Abstract
Newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) pandemic has now spread across the globe in past few months while affecting 26 million people and leading to more than 0.85 million deaths as on 2nd September, 2020. Severity of SARS-CoV-2 infection increases in COVID-19 patients due to pre-existing health co-morbidities. This mini-review has focused on the three significant co-morbidities viz., heart disease, hypertension, and diabetes, which are posing high health concerns and increased mortality during this ongoing pandemic. The observed co-morbidities have been found to be associated with the increasing risk factors for SARS-CoV-2 infection and COVID-19 critical illness as well as to be associated positively with the worsening of the health condition of COVID-19 suffering individuals resulting in the high risk for mortality. SARS-CoV-2 enters host cell via angiotensin-converting enzyme 2 receptors. Regulation of crucial cardiovascular functions and metabolisms like blood pressure and sugar levels are being carried out by ACE2. This might be one of the reasons that contribute to the higher mortality in COVID-19 patients having co-morbidities. Clinical investigations have identified higher levels of creatinine, cardiac troponin I, alanine aminotransferase, NT-proBNP, creatine kinase, D-dimer, aspartate aminotransferase and lactate dehydrogenase in patients who have succumbed to death from COVID-19 as compared to recovered individuals. More investigations are required to identify the modes behind increased mortality in COVID-19 patients having co-morbidities of heart disease, hypertension, and diabetes. This will enable us to design and develop suitable therapeutic strategies for reducing the mortality. More attention and critical care need to be paid to such high risk patients suffering from co-morbidities during COVID-19 pandemic.
Highlights
Coronavirus disease 2019 (COVID-19), caused by newly emerged, single-stranded enveloped RNA virus namely severe acute respiratory syndrome coronavirus - 2 (SARS-CoV2), affects primarily the respiratory tract[1]
The two life style associated conditions of overweight and obesity are identified as potential risks factors towards contributing to severe illness associated in COVID-19 patients[18,21]
The interaction between Dipeptidyl peptidase-4 (DPP-4) and coronavirus has been studied by using the mouse model, in which the results showed that the mouse was susceptible to MERS-CoV116
Summary
Coronavirus disease 2019 (COVID-19), caused by newly emerged, single-stranded enveloped RNA virus namely severe acute respiratory syndrome coronavirus - 2 (SARS-CoV2), affects primarily the respiratory tract[1]. Various kinds of pee-existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility, pose risks of more severity outcomes and deaths in COVID-19 patients by modulating virus-host interactions and host-immune responses, and have some agedependent effects[16,17,18,19,20]. This increase may give explanation of the higher infectivity of SARS-CoV-2 and higher mortality in patients with heart disease[69] These findings are relevant with another study which reported that the SARSCoV-2 can directly replicate in cardiomyocytes and pericytes, causing viral myocarditis[70]. Studies have reported prevalence of CVD, hypertension and diabetes in severely affected SARS-CoV-2 infected patients as 7%, 21% and 11%, respectively[103].
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