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Cardiovascular Effects of COVID-19

COVID-19 has become a global pandemic that has affected the lives of billions of individuals. It is caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cardiovascular disease is analyzed to be linked with worse outcomes and increased risk of death in patients with COVID-19. COVID-19 can also induce myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism.

More than 10 million people have been infected with COVID-19 infection. COVID-19 primarily infects the lungs and the respiratory system. However, the second main target is the cardiovascular system and coagulation mechanisms of the biological system affected due to the viral replication.

The COVID-19 virus is diagnosed to be the primary risk factor for various cardiovascular conditions such as pericarditis, myocarditis, arrhythmias, and myocardial injury, cardiac arrest, heart failure, and coagulation abnormalities. Coronavirus, directly and indirectly, causes tissue damage leading to cardiovascular abnormalities. In recent cases, direct myocardial cell injury and indirect damage to the myocardial cell due to inflammation have been reported.

Cardiovascular Conditions due to COVID-19

Cardiovascular co-morbidity is the major risk factor among people infected with the coronavirus. Tthe his leads to severe COVID-19 cases and might lead to fatality.

Patients with cardiovascular disease usually suffer from 2 or more comorbidities. These often include hypertension and diabetes which increase the risk of severe disease and death. The risk factors increase when combined with advanced age. The cardiac implication of COVID-19 is severe in the case of patients suffering from heart failure and diseases such as ischemic heart disease.

Cardiovascular disease or CVD patients are easily affected with severe COVID-19. COVID-19 infection becomes a serious condition due to various forms of heart condition or heart function including:

  • Hypertension and diabetes – The angio-converting enzyme found in organs such as the nose and lungs is vital for managing blood pressure. This enzyme is identified as the receptor to which the coronavirus binds for the main entry. Medication for hypertension inhibits or block enzyme activity such as ACE inhibitors (ACE-i) and ACE receptor blockers (ARB). These might increase the risk of cardiac problems and thus complicating the COVID-19 infection. Diabetic people are at high risk for COVID-19 related morbidity and makes them more vulnerable to viral infections.

  • Acute coronary syndrome – The “troponins” regulate the contractions of our heart muscle. This can be high in patients suffering from COVID-19 who are not otherwise diagnosed with heart disease. Along with the risk from coronavirus infection, heart patients also face the risk of fatty deposits in the arteries or plaque. This might rupture the arteries and medicines such as aspirin would be a possible therapeutic way forward.

  • Injury to muscles tissues of the heart.

  • Myocardial injury -This is the injury to the thick inner part of the heart muscle. It can be detected by measuring levels of proteins called troponins, which help in regulating the contraction of the heart muscle. COVID-19 leads to an increase in the level of cytokines that sums up the overactive immunity processes. These could directly or indirectly cause some patients to succumb. Cytokines are small proteins released by the cells. They would trigger other cells to join the fight in the inflammatory response.

  • Heart failure – Managing patients with heart failure with suspected or confirmed COVID-19 begins with recognizing that respiratory infection. This is a common trigger of suddenly worsening symptoms– heart failure decompensation. Patients with chronic cardiac conditions, including HF, are predisposed to respiratory infections and to the complications that can occur with signs and symptoms of both cardiac and respiratory conditions overlapping. The high virulence and transmissibility of COVID-19 call for extraordinary efforts to minimize exposure to both patients and medical staff.

  • Rheumatic heart disease, and

  • Chaga’s disease.

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