1. COVID-19-associated cardiovascular morbidity in older adults: a position paper from the Italian Society of Cardiovascular Researches
- Author
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Andrea Gerbino, Tommaso Angelone, Claudia Penna, Pasquale Pagliaro, Carmine Rocca, Vincenzo Lionetti, Luca Munaron, Michele Miragoli, Michele Samaja, Teresa Pasqua, and Francesco Moccia
- Subjects
Male ,Aging ,medicine.medical_specialty ,Pneumonia, Viral ,Review ,Disease ,030204 cardiovascular system & hematology ,Hypoxemia ,Pathogenesis ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Acute myocardial injury ,Endothelial dysfunction ,Intensive care medicine ,Pandemics ,Aged ,030304 developmental biology ,0303 health sciences ,Frailty ,SARS-CoV-2 ,business.industry ,Age Factors ,COVID-19 ,Inflammasome ,Middle Aged ,medicine.disease ,3. Good health ,Cardiovascular system ,Ageing ,Italy ,Cardiovascular Diseases ,Viral pneumonia ,SARS-CoV-2, COVID-19, aging, frailty, cardiovascular system, acute myocardial injury ,Position paper ,Female ,medicine.symptom ,Geriatrics and Gerontology ,Coronavirus Infections ,business ,Cytokine storm ,medicine.drug - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells following binding with the cell surface ACE2 receptors, thereby leading to coronavirus disease 2019 (COVID-19). SARS-CoV-2 causes viral pneumonia with additional extrapulmonary manifestations and major complications, including acute myocardial injury, arrhythmia, and shock mainly in elderly patients. Furthermore, patients with existing cardiovascular comorbidities, such as hypertension and coronary heart disease, have a worse clinical outcome following contraction of the viral illness. A striking feature of COVID-19 pandemics is the high incidence of fatalities in advanced aged patients: this might be due to the prevalence of frailty and cardiovascular disease increase with age due to endothelial dysfunction and loss of endogenous cardioprotective mechanisms. Although experimental evidence on this topic is still at its infancy, the aim of this position paper is to hypothesize and discuss more suggestive cellular and molecular mechanisms whereby SARS-CoV-2 may lead to detrimental consequences to the cardiovascular system. We will focus on aging, cytokine storm, NLRP3/inflammasome, hypoxemia, and air pollution, which is an emerging cardiovascular risk factor associated with rapid urbanization and globalization. We will finally discuss the impact of clinically available CV drugs on the clinical course of COVID-19 patients. Understanding the role played by SARS-CoV2 on the CV system is indeed mandatory to get further insights into COVID-19 pathogenesis and to design a therapeutic strategy of cardio-protection for frail patients.
- Published
- 2020
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