Журнал инфекционных заболеваний и терапии

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Findings on the Relationship between Cardiovascular Disease and Coronavirus Disease 2019: A Systematic Review

Yuri Henrique da Silva, José Gildo de Moura Monteiro Júnior, Rosângela Ferreira Frade de Araújo

Coronavirus disease 2019 (COVID-19) presents as the main cause of death, respiratory and heart failures, especially in the elderly, immunosuppressed, and those with cardiovascular comorbidities. Therefore, a better understanding of these findings is needed. A systematic review was carried out looking for articles published on the MEDLINE/PubMed using the following descriptors: ("cardiovascular disease") OR ("acute myocardial infarction") OR ("coronary artery disease") OR ("acute coronary syndrome") OR ("atherosclerosis") OR ("cardiac insufficiency") OR ("pericarditis") OR ("myocarditis") AND ("COVID-19") OR ("SARS-CoV-2") and considering inclusion and exclusion criteria. Of the total number of patients included in the 10 studies selected for this review, 40% of patients infected with SARS-CoV-2 had hypertension or other cardiovascular comorbidities, while 27% presented cardiovascular complications, mainly acute cardiac injury, arrhythmia, and heart failure. The hypotheses of involvement of an intense inflammatory response, decreased immunity and greater expression of ACE2 in the heart, associated with more severe heart conditions, were discussed in this study. The increase in cardiac and inflammatory markers was associated with worse clinical outcomes and risk of death, confirming the need to evaluate them since admission to the hospital. The articles analyzed presented as a limitation the small number of patients inserted, to the detriment of the pandemic state. We warned about the need for better clinical management of patients with cardiovascular comorbidities aiming at reducing the number of fatal cases due to infection.