COVID-19 and the World with Co-Morbidities of Heart Disease, Hypertension and Diabetes

Abstract

Newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) pandemic has now spread across the globe in past few months while affecting 26 million people and leading to more than 0.85 million deaths as on 2nd September, 2020. Severity of SARS-CoV-2 infection increases in COVID-19 patients due to pre-existing health co-morbidities. This mini-review has focused on the three significant co-morbidities viz., heart disease, hypertension, and diabetes, which are posing high health concerns and increased mortality during this ongoing pandemic. The observed co-morbidities have been found to be associated with the increasing risk factors for SARS-CoV-2 infection and COVID-19 critical illness as well as to be associated positively with the worsening of the health condition of COVID-19 suffering individuals resulting in the high risk for mortality. SARS-CoV-2 enters host cell via angiotensin-converting enzyme 2 receptors. Regulation of crucial cardiovascular functions and metabolisms like blood pressure and sugar levels are being carried out by ACE2. This might be one of the reasons that contribute to the higher mortality in COVID-19 patients having co-morbidities. Clinical investigations have identified higher levels of creatinine, cardiac troponin I, alanine aminotransferase, NT-proBNP, creatine kinase, D-dimer, aspartate aminotransferase and lactate dehydrogenase in patients who have succumbed to death from COVID-19 as compared to recovered individuals. More investigations are required to identify the modes behind increased mortality in COVID-19 patients having co-morbidities of heart disease, hypertension, and diabetes. This will enable us to design and develop suitable therapeutic strategies for reducing the mortality. More attention and critical care need to be paid to such high risk patients suffering from co-morbidities during COVID-19 pandemic.

Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

“…According to epidemiological data, most deaths from COVID-19 are concentrated in the elderly with common comorbidities such as hypertension, diabetes or obesity (62)(63)(64). In general, this group of individuals has a higher prevalence of zinc deficiency (65)(66)(67)(68)(69), given that aging is associated with a progressive decline in zinc status in the body due to several factors, including reduced food intake, decreased nutrient absorption efficiency and use of medications (70,71).…”

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

“…Increased blood levels of markers of cardiometabolic dysfunction, such as creatinine kinase, aspartate aminotransferase and cardiac troponin 1 have been detected in people who died from COVID-19, compared to those who recovered ( 131 ). These observations may be linked to complications of cardiovascular disease induced by COVID-19, such as cardiomyocyte necrosis, hypertension and coronary plaque instability ( 131 ) Other hypothesized mechanisms that could increase risk of COVID-19 severity in people with cardiometabolic disease include: diminished lung function; pre-existing lung damage (including lipofibrosis in lungs ( 132 ); impaired pancreatic beta-cell function ( 131 ); poor responsiveness/capacity for mechanical ventilation; impaired fibrinolysis capacity and pulmonary perfusion; dysregulated endocrine function; and, gut dysbiosis ( 133 , 134 ). Non-medical factors that associate with increased risk include poverty and over-crowded housing conditions that likely reduce the capacity of individuals to undertake social isolation recommendations, and promote viral spread ( 125 ).…”

TLR9 and COVID-19: A Multidisciplinary Theory of a Multifaceted Therapeutic Target

“…Early epidemiological data revealed that SARS-CoV-2 is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as ARDS and multiple organ failure ( Chen et al, 2020 ). Reported comorbidities in infected patients that require hospital admission include cardiovascular disease/heart disease, diabetis mellitus, chronic respiratory disease, hypertension and cancer ( Butchi et al, 2011 ; Arumugam et al, ; Huang et al, 2020 ; Wu and McGoogan, 2020 APR 7). Obesity, has been positioned as common denominator of impaired metabolic health, respiratory dysfunction, cardiovascular disease and diabetes mellitus in the severe course of COVID-19 ( Stefan et al, 2020 ).…”