Susceptibility and prognosis of COVID-19 patients with cardiovascular disease
Brian Wang
Abstract
The outbreak of5 COVID-19, first identified in Wuhan, the capital of Hubei, China, in December 2019 has spread globally. Currently, we have no vaccine or specific antiviral treatment for the disease. Relatively little is known about the interplay between the disease with other comorbidities, including cardiovascular disease (CVD) and medications.1 Here, we outline what is known about the susceptibility of patients with CVDs to COVID-19 and the relative risk of these patients succumbing to severe illness. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), phylogenetically related to the beta coronavirus SARS that caused a global outbreak in 2002. Coronaviruses contain four structural proteins, including spike (S), envelope, membrane and nucleocapsid.2 The S protein plays the most vital role in viral attachment, by binding to angiotensin-converting enzyme 2 (ACE2) in the lungs.3 In this way, these coronaviruses anchor to the lower respiratory tract of humans. The receptor binding domain of the SARS-CoV-2 S protein is therefore a likely target for the development of virus attachment inhibitors, neutralising antibodies and vaccines. Early studies in China investigated the prevalence of comorbidities in patients with COVID-19. In a study conducted on 138 hospitalised patients with COVID-19 at Zhongnan Hospital of Wuhan University from 1st January 2020 to 28th January 2020, half of these patients had at least one comorbidity, with hypertension (31%) and CVD (14.5%) being the two most common, and diabetes (10%) the third most common, demonstrating that CVD is common in patients with COVID-19.4 The criteria for inclusion as CVD for this study was not described. Patients with heart failure have previously been shown to be more likely to contract viral illnesses, although the mechanism underlying …