The cardiovascular aspect of COVID-19

Abstract

The coronavirus disease-2019 (COVID-19), an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2), has hit the world very hard by affecting millions of people across countries hence posing a major health threat on a global scale. This novel virus is thought to enter and cause infection in its host through the attachment of its structural protein known as the S-glycoprotein to angiotensin-converting enzyme 2 (ACE2). Given the rapid spread of COVID-19 with its consequences globally, it is mandatory that health caregivers and researchers across all disciplines abreast themselves with the potential effects that this novel virus may have on their fields and the medical society at large. During the infection, the cardiovascular system is affected by unknown pathomechanistic processes, hence accounting for an increased prevalence of cardiovascular diseases (CVDs) among COVID-19 patients. As cardiovascular researchers, we are more concerned about the cardiovascular aspect of SARS-CoV-2/COVID-19. Hence, this concise review addresses these aspects where CVD as a risk factor of COVID-19, the prevalence of CVDs in COVID-19, and the potential cardiovascular disorders which may evolve owing to COVID-19 are discussed. A better understanding of these issues will be pivotal to improve cardiovascular health during this SARS-CoV-2/COVID-19 pandemic and beyond.

Keywords: COVID-19; SARS-CoV-2; acute respiratory distress syndrome; angiotensin-converting enzyme 2; cardiovascular disease.

Figure 1.

Schematic of the probable mechanisms for the direct and indirect impact of COVID-19 on CVS. The direct effect is initiated in the CVS while, the indirect effect begins in the lung when the SARS-CoV-2 Spike protein attaches to ACE2. In both instances, ACE2 are internalised, thereby, disrupting the exertion of its protective effects. Directly, ACE2 downregulation along with other pre-existing CV complications exacerbates CV dysfunction. Indirectly, ACE2 downregulation in the lungs induces respirational dysfunctions which affects CV function by induction of hypoxaemia, ischaemia, myocardial and other CV complications. The effect of SARS-CoV-2 on the respiratory system, coupled with the likely synergy (+) of its direct and indirect impacts on the CVS might be resulting in the heart failures occurring in COVID-19 patients.