“…Several physiological changes, associated with psychological distress during the pandemic, can predispose patients to or worsen cardiovascular disease including increased oxidative stress, catecholamine, cortisol levels, aggregation of platelet, inflammatory cells, endothelial dysfunction, and stimulation of the sympathetic nervous system [ 47 , 48 ]. Anxiety and fear are psychological disorders that can coexist with heart failure and other cardiovascular diseases, and are even considered major risk factors for cardiovascular disease such as coronary artery disease, stress-cardiomyopathy, arrhythmias, stress-cardiomyopathy, myocarditis, cardiogenic shock, and cardiac arrest [ 48 , 49 ].…”