COVID-19 and cardiovascular complications: an update from the underlying mechanism to consequences and possible clinical intervention

ABSTRACT

Introduction: The novel coronavirus has caused significant mortality worldwide and is primarily associated with severe acute respiratory distress syndrome (ARDS). Apart from ARDS, clinical reports have shown noticeable cardiovascular complications among the patients of COVID-19. Infection from virus, stimulation of cytokine storm, altered immune response, and damage to myocardial tissue are some of the proposed mechanisms of cardiovascular complications in COVID-19.

Areas covered: Based on the clinical reports of CVDs among COVID-19 patients, we have discussed the molecular mechanisms involved in cardiovascular pathogenesis, its prevalence, and association with COVID-19, and various available therapeutic modality for the treatment.

Expert opinion: Seeing the cardiovascular complications in COVID-19 patients and its association with the existing drug, risk–benefit ratio of treatment paradigm, as well as the level of cardiac injury biomarkers must be monitored regularly. Additionally, a well-designed clinical trial should be conducted where head to head comparison can be made with anti-COVID-19 drugs and cardioprotective anti-inflammatory drugs. Nevertheless, vaccines are the best-suited approach, but until then, sanitization, social distancing, and active lifestyle are the best ways to beat this global pandemic situation.

KEYWORDS:

• Cytokine storm; Pneumocytes; Cardiotoxicity; NLRP3 inflammasome and COVID-19

Article highlights

• The novel coronavirus (nCoV-19) began in China and now has taken the shape of a global pandemic.

• Acute respiratory distress syndrome (ARDS), pyrexia, body ache, and pulmonary toxicity are some of the common clinical presentations of nCoV-19.

• Published evidences also showed significant cardiotoxicity among the patients who were diagnosed with nCoV-19.

• A number of published meta-analysis, case studies, and case series have shown that not only does nCoV-19 infection worsen cardiovascular complications, but also makes the patient susceptible to such infection.

• Studies have also reported cardiotoxic side effects of several anti-CoV-19 drugs.

• To take care of such a complex issue, a more detailed molecular pathogenesis of cardiovascular complication in CoV-19 infection is needed to understand which will help in developing a safer and effective cardioprotective anti-nCoV-19 drugs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.