Cardiovascular patients, more vulnerable to COVID-19 - experts

A closer look at the casualties caused by a novel type of coronavirus reveals that COVID-19 patients with cardiovascular or heart conditions appear to be especially vulnerable, according to Nature Review.

During the months succeeding the outbreak in the city of Wuhan in Hubei, China in December 2019, the Chinese Center for Disease Control and Prevention has published the largest case of COVID-19 in the country by February 2020. However, in March 2020, Italy has overtaken China and surpassed the latter as the worst-hit country with more reported deaths.

Based on a report from the National Institute of Health in Italy, 99 percent of COVID-19 patients who have died had a preexisting condition. Thus number includes high blood pressure, heart disease, diabetes, and kidney disease, and 76.1 percent of the patients who died from COVID-19 had cardiovascular conditions such as hypertension or high blood pressure. In contrast, 1/3 of the patients had heart disease.

Moreover, among the 44,600 confirmed COVID-19 cases in China, the fatality rate of patients with the preexisting or underlying condition was at a 10.5 percent for those with cardiovascular diseases compared to the overall rate at 2.3 percent.

According to the British Heart Foundation, anybody is likely to catch the virus. However, anyone with a heart or circulatory condition is at a higher risk of getting more ill. They are also at risk of acquiring complications upon contracting the coronavirus.

The foundation also enumerates some heart patients that are at extremely high risk, and this includes individuals who have had any transplant. It applies to heart transplant patients as well, and pregnant women who have any significant heart disease and a congenital heart condition.

To attack or invade a cell, severe acute respiratory syndrome - coronavirus 2 or SARS-CoV-2, the virus that causes COVID-19, latches itself onto angiotensin-converting enzyme 2 (ACE2), which is an enzyme that has a crucial role in the immune and cardiovascular systems. ACE2 is vital in heart function, and it is involved in the development of diabetes mellitus and hypertension. Moreover, in the ACE2 study conducted by Anthony Turner, Julian Hiscox, and Nigel Hooper, ACE2 has been known as a functional receptor for coronaviruses, which includes SARS-CoV and SARS-CoV-2.

ACE2 has been associated with heart function, hypertension, and diabetes, as discussed in the study. ACE2 also serves as the cellular entry or access point for the SARS virus, and the enzyme is, therefore, a primary target for several interventions, whether medical or pharmacological, on disease fronts.

This enzyme is found on the lungs' cells, and therefore, when the virus invades, this causes respiratory problems and other symptoms. Besides, since ACE2 is also found in the cells that line the blood vessels, COVID-19 may cause direct damage to the heart and the cardiovascular system.

As reported in JAMA Cardiology on March 25, about 20 percent of more than 400 hospitalized patients in Wuhan with COVID-19 have shown signs of heart injury. With this increased complications, fatality risks in patients have been further amplified, resulting in the death of half of the number of patients with heart damage.