Adverse Effects Of COVID-19 On Patients With Cardiovascular Disorders In General Heart Failure And In Particular

Background and Aim: This thesis dealt with the effects and outcomes of Coronavirus disease 2019(Covid-19)on patients with cardiovascular disorders(CVD)and heart failure in particular.Coronaviruses are a large family of single positive-stranded,enveloped RNA viruses that can infect many animal species and humans.Human coronaviruses can be divided based on their pathogenicity.The types with high pathogenicity include SARS-CoV,MERS-CoV,and current novel SARS-CoV2.The general aim of this thesis was to describe the diagnostic and epidemiological aspects in the general population and to evaluate the potential effect and implications for patients with cardiovascular disease in general and heart failure in particular.Methods: Given the time-sensitive nature of the challenges associated with this outbreak,I reviewed the published reports(including multiple search strategies in MEDLINE with PubMed interface)and critically assessed early reports on medRxiv,a preprint server(date of the last search: May 10,2020).Because the initial epicenter for this outbreak was from China,themajority of data on patients with COVID-19 are from this region.Although a systematic attempt was made to include reports and viewpoints from other heavily affected countries,data related to CV risk factors or presentations were limited.Results: While most of the patients(80%)will get a mild form of the disease.The severe form of the disease occurs in about 15% of patients requiring hospitalization and critical form occurs in about 5% of patients requiring intensive care.A study carried out by Bo Li,Meta-analysis of the study has revealed that hypertension is the most prevalent comorbidities of CVMs,it affects 17% of the patients badly,while cardio-cerebrovascular disease affected 16.4% of the patients and lastly,it is diabetes that affected9.7%.Experts have focused on the effects of COVID-19 on patients of cardiovascular issues.Their collected data has revealed that 80% of the patients might have acute coronary injuries.The data obtained when compared between the patients in intensive care units and the non-ICU patients,experts have said that ICU patients have significantly higher incidences of CVD than others.In a cohort of 21 intensive care severely sick patients with COVID-19,one third developed cardiomyopathy.Also,patients should be monitored for signs of right-side heart failure secondary to pulmonary hypertension as a result of hypoxia.A cohort of 191 patients with COVID-19(Zhou et al.)44 patients(23%)had new or worsening heart failure,28 patients survived,and 16 died.The major cause of death inCOVID-19 is a respiratory illness,but there is also significant other vital organ involvement,including the cardiovascular system and shock.The current mortality rate ranges between 2% to 5% of all patients with COVID-19 but is much higher in patients requiring invasive mechanical ventilation.Since this is an emerging infectious disease,there is,as of yet,constrained information on the impacts of this infection on patients with cardiovascular disease,especially for those with heart failure.Nonetheless,the presence of chronic cardiac diseases or cardiac involvement will have a higher mortality rate in comparison to patients without cardiovascular disease.Conclusions: The outbreak of COVID-19 has become a clinical threat to the general population and healthcare workers worldwide.However,knowledge about this novel virus remains limited.Despite the rapidly growing number of clinical trials,no definitive therapies(other than supportive care)are available at this time.Among the confirmed cases of Covid-19,patients with heart failure,and other comorbidity yielded poorer clinical outcomes than those without.A greater number of comorbidities also correlated with worse clinical outcomes.A thorough assessment of comorbidities may help establish the risk stratification of patients with Covid-19 upon hospital admission.