Respiratory and cardiovascular effects of COVID-19 infection and their management

Abstract

The COVID-19 epidemic has put an enormous burden on the health-care system and the economy. The virus has very high infectivity and is crippling in patients developing severe disease. The disease caused by this infective agent, a novel RNA coronavirus (SARS-CoV-2), was named by the World Health Organization as COVID-19. SARS-CoV-2 usually enters the human body from the respiratory tract and gradually causes systemic disease. The disease is mild in 81% and severe in the balance. The virus causes multiorgan damage and primarily damages airway epithelium, small intestine epithelium, and vascular endothelium, which are organs with high angiotensin-converting enzyme (angiotensin-converting enzyme-2 [ACE2] expression). The most affected organ is the lungs, and the cardiovascular system follows it closely. Symptomatic hypoxic patients are initially treated with oxygen supplementation, but those with severe hypoxia need mechanical ventilation support. Patients with COVID-19 infection present as two phenotypes. The ventilation strategy should be based on the phenotype. The disease causes major hemodynamic disturbances in its invasion of the cardiovascular system. Strict personal protection protocols are needed to ensure the safety of health-care workers and nosocomial spread.

Keywords: COVID-19; hemodynamic management COVID; respiratory management COVID.

Figure 1

Respiratory features of different stages of COVID-19 infection

Figure 2

Chest X-ray of two patients revealing bilateral peripheral focal or multifocal infiltrates or white opacities

Figure 3

High-resolution computerized tomographic longitudinal and axial scan images of a patient revealing characteristic fluid containing multilobar and subsegmental areas of consolidation, with ground-glass appearance with a crazy-paving pattern

Figure 4

Respiratory management of different stages of COVID-19 infection