Abstract
CLINICAL COURSE AND MANAGEMENT OF COVID-19 IN PATIENTS WITH PRE-EXISTING CARDIOVASCULAR DISEASE

Iyanu V. Olateju MD, MHA*, Omotola Emmanuel MD, MBA, Ruth E. Pius MBBS, Adejoke O. Dada-Bello M.B.Ch.B and Peace C. Asuzu MD, MPH

ABSTRACT

Since the beginning of the Coronavirus outbreak in December 2019, there have been many comorbidities and complications associated with this respiratory illness. Among these are cardiovascular diseases (CVD). Multiple studies have reported an exacerbation of pre-existing cardiovascular conditions in COVID-19 patients, as well as increased morbidity and mortality. Other studies reported an association of COVID-19 with the incidence of cardiovascular diseases. Either way, the inflammatory process involved in the pathogenesis of COVID-19 infection has been reported as a potential cause of myocardial injury, especially in critically ill patients. This review aimed at investigating the pathogenesis and impact of COVID-19 on patients with pre-existing cardiovascular diseases. Beyond establishing an association, we also focused on the mechanisms of myocardial injury in COVID-19 patients and the management approach. We searched PubMed and Google Scholar for this review from May 1, 2016, through May 1, 2021. We selected publications reporting the pathogenesis, association, and outcome of the disease process in COVID-19 patients with cardiovascular diseases and finalized 14 critically appraised articles for this review. After a careful analysis, most studies reported an exacerbation of the disease process in covid-19 patients with pre-existing cardiovascular diseases. This exacerbation was associated with an exaggerated inflammatory response to the coronavirus, which caused a myocardial injury. Few studies indicated that myocardial injury is not limited to COVID-19 patients and could also occur in any critically ill patient. In conclusion, COVID-19 patients with cardiovascular conditions are at increased risk for complications and mortality and, therefore, should be monitored closely and treated promptly.

Keywords: cardiovascular disease, comorbidities, COVID-19.


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