Although COVID-19 is primarily a respiratory condition, many patients may suffer from cardiovascular consequences which range from arrhythmia to heart failure, especially in those with pre-existing cardiovascular diseases and advanced age. Understanding the mechanisms behind why cardiovascular consequences are higher in COVID-19 compared to flu is important in bettering our understanding of the disease and how to treat it effectively.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection typically results in either asymptomatic or mild-moderate COVID-19 severity in the vast majority of people. However, in specific age groups (especially those over 65) and those with pre-existing health conditions (including cardiovascular diseases, diabetes, hypertension, etc), the risk of severe disease is much higher and can require intensive care unit admission in hospital, or in some cases death.

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Cardiovascular/cardiac implications in COVID-19

In severe disease, multi-organ system failure and acute respiratory distress syndrome (ARDS) can lead to death. At the center of the most severe clinical manifestation of COVID-19 is the presence of substantially elevated cytokines (cytokine-release syndrome) which include granulocyte colony-stimulating factor (GCSF), interferon-inducible protein 10, macrophage inflammatory protein-1A and tumor necrosis factor (TNF)-alpha. In addition, those who have myocardial injury also show substantially elevated interleukin-6 (IL-6) levels, suggesting the severity of disease corresponds to the levels of circulating cytokines.