COVID-19 Severity: Lung-Heart Interplay

Abstract

Abstract:: In December 2019, a novel COVID-19 caused by SARS-CoV-2 has emerged as a global emergency. In a few months, the pathogen has infected millions of people in the world. Primarily SARS-CoV-2 infects the pulmonary system which ultimately leads to ARDS and lung failure. The majority of patients develop milder symptoms but the infection turns severe in a huge number of people which ultimately results in enhanced mortality in COVID-19 patients. Co-morbid conditions primarily cardiovascular complications and diabetes have been reported to show a strong correlation with COVID-19 severity. Further, the onset of myocardial injury secondary to pulmonary damage has been observed in critically ill patients who have never reported heart-related ailments before. Due to drastic health risks associated with virus infection, the unprecedented disruption in normal business throughout the world has caused an economic misery. Apparently, newer treatments are urgently needed to combat the virus particularly to reduce the severity burden. Therefore, understanding the cross-talk between lung and heart during COVID-19 might give us better clarity for early-diagnosis followed by appropriate treatment in patients with the likelihood of developing severe symptoms. Accordingly, the present review highlights the potential mechanisms that may explain the cross-talk between lung and heart so that effective treatment/management strategies can be evolved swiftly in this direction.

The mechanism underlying extrapulmonary complications of the coronavirus disease 2019 and its therapeutic implication

“… 180 ARDS can induce renal medullary hypoxia, which is an additional insult to tubular cells. 180 In addition, lung–heart, 181 gut–lung, 182 and brain–lung interactions, 183 etc., have also been proposed as potential underlying mechanisms of SARS-CoV-2-induced multiorgan dysfunction.…”

Computational Mutagenesis at the SARS-CoV-2 Spike Protein/Angiotensin-Converting Enzyme 2 Binding Interface: Comparison with Experimental Evidence

“…If not treated promptly and efficiently, ARDS can dramatically turn into cytokine storms, multiorgan failure, septic shock, and blood clots . Longer-term damage to organs (lungs and heart, in particular) has also been reported . Last but certainly not least, there is a growing concern about the number of patients who, after recovering from COVID-19 acute phase, continue to experience a range of disease effectsknown as long COVIDfor months afterward …”

“…8 Longer-term damage to organs (lungs and heart, in particular) has also been reported. 9 Last but certainly not least, there is a growing concern about the number of patients who, after recovering from COVID-19 acute phase, continue to experience a range of disease effectsknown as long COVIDfor months afterward. After the adoption of strong measures to counteract the pandemic outbreak and the subsequent successful containment of viral spreading, unfortunately many countries around the world are now witnessing a resurgence in COVID-19.…”

The Significance of Low Magnesium Levels in COVID-19 Patients

“…Infection with SARS-CoV-2 induces a prothrombotic and proinflammatory state that can increase the risk of serious thrombotic disorders in patients both during acute infection and in the post-COVID-19 period [ 130 , 131 , 132 ]. In COVID-19, aberrant inflammatory response in combination with hypoxia has been associated with endothelial dysfunction, imbalance of pro- and anticoagulant factors, and thrombin generation, leading to thromboembolic events [ 130 , 131 , 133 ]. In patients with COVID-19, the impairment of lung function can be linked to increases in blood pressure [ 133 ].…”

“…In patients with COVID-19, the impairment of lung function can be linked to increases in blood pressure [ 133 ]. Moreover, pulmonary and venous thromboembolisms can cause severe cardiovascular problems, such as myocardial damage and cardiac and cerebral ischemia [ 130 , 131 , 132 , 133 , 134 ].…”