COVID-19 and the Cardiovascular System: How the First PostModern Pandemic ‘Weakened’ our Hearts

Abstract

The global spread of SARS-CoV-2 with its diverse signs and symptoms manifested in COVID-19 patients across different age groups and geographic locations perplexed the clinicians and public health experts. Emerging variants of SARS-CoV-2 through continuous mutation with a limited arsenal of treatment made the study of viral pathogenesis and factors associated with disease outcomes in a holistic approach inevitable, among which pre-existing cardiovascular complications were found to be significantly associated with adverse outcome of COVID-19. In addition, COVID-19 has already been reported to cause cardiac injury and different cardiovascular complications in patients irrespective of preexisting cardiovascular complications, which highlights the importance of recognizing the complications at the onset, although these arising complications might be an indirect effect of SARS-CoV-2 induced cytokine storm or hypoxia rather the virus itself. Also, the drugs used for the clinical management of the patients may have an impact on the induced cardiac complications. Thus, the effect of SARS-CoV-2 on the cardiovascular system needs to be investigated in order to predict the clinical outcome and to devise a proper treatment strategy. Besides, the interaction of vaccines or therapeutics to be approved with the cardiovascular system needs to be evaluated to avoid confounding effects leading to cardiovascular complications followed by post-approval retraction. However, potential biomarkers (eg. troponin, D-dimers, fibrin) associated with cardiac injury may be potentially useful in predicting life-threatening conditions early enough to save lives. In conclusion, this review summarizes the molecular pathogenesis of cardiovascular damage caused by SARS-CoV-2 in COVID-19 patients, as well as prescribed treatment and preventative measures.