3 | NOT ONLY FIGHTING AGAINST COVID-19, BUT ALSO LOWERING CARDIOVASCULAR RISK
According to a new report on cardiovascular diseases (CVD) in China (22), there are 290 million patients with CVD and the prevalence and death rate are still on the rise, and CVD remains the No. 1 “killer” of global residents. Thus, it’s time to strengthen the prevention and treatment of CVD, diabetes, and cancer during fighting against and after combating Covid-19. At the same time, it’s very important to speed up the development, clinical trials, and application of antiviral drugs and Covid-19 vaccines.
Not only fighting against Covid-19 but also effectively lowering cardiovascular risk should be done better, because there are obviously weight gain and abnormal indicators among CVD patients during the Covid-19 pandemic lockdown and restrictions. If not enough preventive measures, many individuals preexisting CVD may die not of Covid-19 but major adverse cardiocerebrovascular events (MACCE), such as cardiac injury, cardiac arrest, acute coronary syndrome, heart failure, stroke, and other unexpected events.
There are myocardial inflammation (23) in patients with COVID-19 due to an immune-mediated myopathy by SARS-CoV-2 infection (24). Actually, there is myocarditis among 33.3% of Covid-19 confirmed cases (25). Herein, SARS-CoV-2-induced myocarditis, endothelial injury, and microvascular/macrovascular thrombosis are common pathophysiological features (26, 27). There is also acute myocardial injury including both epicardial vessel thrombosis and microvascular thrombosis identified by cardiovascular magnetic resonance (CMR) imaging in Covid-19 cases (28).
In some cases, post-vaccination myocarditis may occur (29, 30), but it remains unceitain (31), hence, long follow-up is needed. There were also slight cardiac abnormalities (imaging features of pericardial inflammation) in college student athletes (32). Some cases may suffer from cardiac arrest (33). There are also common atrial arrhythmias (atrial fibrillation or atrial flutter, AF/AFL) due to the systemic inflammation of severe viral illnesses (34), even postural orthostatic tachycardia syndrome (35). Covid-19 cases treated with hydroxychloroquine and azithromycin (HCQ/AZM) had an increase in corrected QT (QTc) prolongation (36). These problems on cardiovascular health are direct or indirect consequences related to infection of the SARS-CoV-2 and its variants (37). Thus, during the Covid-19 pandemic, there was an increase in deaths in the US due to CVD including ischemic heart disease and hypertension (38).