Findings on the relationship between cardiovascular disease and coronavirus disease 2019: a systematic review

Abstract

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 between December 2019 and May 2020 on the MEDLINE / PubMed search platform 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.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 10 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, and the importance of including this group among the first to be immunized, aiming at reducing the number of fatal cases due to infection. Studies with greater coverage are needed for a better comprehension of the topics discussed here.