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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogenic cause of COVID-19, an ongoing global pandemic. In addition to anticipated respiratory mortality, there is an increasing recognition of cardiovascular morbidity and mortality in this population.1–4 In hospitalised patients with COVID-19, prevalent cardiovascular disease (CVD) and the presence of cardiac injury have each been associated with in-hospital mortality (table 1). While similar associations have been reported in other coronavirus epidemics, including SARS and Middle East respiratory syndrome,5 the potential impact of CVD and injury in COVID-19 remains a critical knowledge gap. Further clarity would not only facilitate the identification of at-risk populations who qualify for closer monitoring but additionally frame investigation of shared pathophysiology that could guide development of targeted therapies. View this table: Table 1 Increased risk of adverse outcomes with underlying CVD and COVID-19 infection In this issue of Heart, Zhang and colleagues6 present a retrospective, cohort study of patients with COVID-19 admitted to a single hospital in Wuhan, China between 11 January and 6 February 2020. The authors examine the prevalence of CVD among admitted patients and compare clinical characteristics in those with and without CVD. Using logistic regression models, they evaluate the association between CVD and a range of clinical outcomes including all-cause mortality and clinical recovery from infection. After excluding 119 patients with incomplete clinical history and laboratory data, the study cohort was comprised of 541 patients in whom approximately one-quarter had a history of prevalent CVD. The most common cardiovascular morbidity was hypertension (HTN; 23% of total cohort) followed by coronary artery disease (8%) and arrhythmia (2%). A minority (7%) of patients had more than one CVD type at baseline. When compared with patients without CVD, those with CVD were older and had a greater prevalence of severe infection, end-organ injury (acute kidney injury, acute liver …