International Journal of Cardiovascular ResearchISSN: 2324-8602

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Short Communication, Icrj Vol: 10 Issue: 9

Potential Mechanisms Underlying Covid-19, Paving the Way towards the Development of Preventative and Therapeutic Solutions

Author Name: Anderson

Abstract

Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic that has affected the lives of billions of individuals. Extensive studies have revealed that SARS-CoV-2 shares many biological features with SARS-CoV-2, the zoonotic virus that caused outbreak of severe acute respiratory syndrome, including the system of cell entry, which is triggered by binding of the viral spike protein to angiotensin-converting enzyme. Clinical studies have also reported an association between COVID-19 and cardiovascular disease. Pre-existing cardiovascular disease seems to be linked with worse outcomes and increased risk of death in patients with COVID-19, whereas COVID-19 itself can also induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism. Potential drug-disease interactions affecting patients with COVID- 19 and comorbid cardiovascular diseases are also becoming a serious concern. In this Review, we summarize the current understanding of COVID-19 from basic mechanisms to clinical perspectives, focusing on the interaction between COVID-19 and the cardiovascular system. By combining our knowledge of the biological features of the virus with clinical findings, we can improve our understanding of the potential mechanisms underlying COVID-19, paving the way towards the development of preventative and therapeutic solutions. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensating through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patients with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation.

Keywords:

Introduction: Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic that has affected the lives of billions of individuals. Extensive studies have revealed that SARS-CoV-2 shares many biological features with SARS-CoV-2, the zoonotic virus that caused outbreak of severe acute respiratory syndrome, including the system of cell entry, which is triggered by binding of the viral spike protein to angiotensin-converting enzyme. Clinical studies have also reported an association between COVID-19 and cardiovascular disease. Pre-existing cardiovascular disease seems to be linked with worse outcomes and increased risk of death in patients with COVID-19, whereas COVID-19 itself can also induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism. Potential drug-disease interactions affecting patients with COVID- 19 and comorbid cardiovascular diseases are also becoming a serious concern. In this Review, we summarize the current understanding of COVID-19 from basic mechanisms to clinical perspectives, focusing on the interaction between COVID-19 and the cardiovascular system. By combining our knowledge of the biological features of the virus with clinical findings, we can improve our understanding of the potential mechanisms underlying COVID-19, paving the way towards the development of preventative and therapeutic solutions. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensating through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patients with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation. Early phase symptomatic patients suffer from mild respiratory symptoms and may require supportive care like supplemental oxygen followed by an adaptive immunity stage with falling titers of the virus and resolution of symptoms. The second stage includes several mechanisms leading to pulmonary tissue injury, vasodilation, endothelial permeability and leukocyte recruitment that cause further pulmonary damage, hypoxemia, and cardiovascular stress. Ten percent of patients in the second stage may experience further exacerbation of immune response (hyper inflammation stage) become critically-ill, and they may suffer from Acute Respiratory Distress Syndrome (ARDS), acute cardiac injury, multi-organ failure, secondary bacterial infections, sepsis and require intensive care Accumulated evidence suggests that cardiac involvement is common, particularly in a patient hospitalized with COVID-19 disease. While if the same is true for all infected, symptomatic and asymptomatic people are unclear due to lack of vigilance on this cohort given the violent outburst of the disease forcing concentration of resources on hundreds if not thousands of hospitalized patients. Most of the meager available resources were also geared towards that cohort due to the sudden rise of cases world over with severe sickness and deaths that were noted. Acute myocarditis presents across a variable range of clinical severity and is a significant diagnostic challenge in the COVID- 19 era. Patients with COVID-19 can present with chest pain, dyspnea, dysrhythmia, and acute left ventricular dysfunction.

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