Insights into Cardiovascular Defects and Cardiac Epigenome in the Context of COVID-19

Abstract

Although few in number, studies on epigenome of the heart of COVID-19 patients show that epigenetic signatures such as DNA methylation are significantly altered, leading to changes in expression of several genes. It contributes to pathogenic cardiac phenotypes of COVID-19, e.g., low heart rate, myocardial edema, and myofibrillar disarray. DNA methylation studies reveal changes which likely contribute to cardiac disease through unknown mechanisms. The incidence of severe COVID-19 disease, including hospitalization, requiring respiratory support, morbidity, and mortality, is disproportionately higher in individuals with co-morbidities. This poses unprecedented strains on the global healthcare system. While their underlying conditions make patients more susceptible to severe COVID-19 disease, strained healthcare systems, lack of adequate support, or sedentary lifestyles from ongoing lockdowns have proved detrimental to their underlying health conditions, thus pushing them to severe risk of congenital heart disease (CHD) itself. Prophylactic vaccines against COVID-19 have ushered new hope for CHD. A common connection between COVID-19 and CHD is SARS-CoV-2’s host receptor ACE2, because ACE2 regulates and protects organs, including the heart, in various ways. ACE2 is a common therapeutic target against cardiovascular disease and COVID-19 which damages organs. Hence, this review explores the above regarding CHDs, cardiovascular damage, and cardiac epigenetics, in COVID-19 patients.

Developmental Impacts of Epigenetics and Metabolism in COVID-19

“…This revealed differentially methylated sites in the heart (172 sites) and kidney (49 sites), suggesting that tissue-specific epigenetic changes occur soon after SARS-CoV-2 infection [13]. Other studies have also reported the adverse effects of COVID-19 on the heart [14]. These findings help us to better understand COVID-19's disease presentation, suggesting that SARS-CoV-2 induces metabolic reprogramming and epigenetic changes, which may contribute to systemic toxicity.…”

The Use of Epigenetic Biomarkers as Diagnostic and Therapeutic Options

“…Kelsey Dawes et al explore epigenetic analyses of alcohol consumption in combustible and non-combustible nicotine product users in a biochemically verified cohort of exclusive cigarette smokers [ 5 ]. Shreya Sarkar et al present the current scenario of cardiovascular diseases and congenital heart defects associated with COVID-19 patients and provide a developmental biology perspective of the roles of angiotensin-converting enzyme 2 (ACE2) and its axis members [ 6 ].…”