[COVID-19 and the impact of cardiovascular comorbidities].

Seoudy, Hatim; Frey, Norbert

Since its outbreak, coronavirus disease 2019 (COVID-19) has rapidly resulted in a global pandemic. Underlying cardiovascular disease (CVD) is associated with severe COVID-19 infection and adverse clinical outcomes. While COVID-19 predominantly causes respiratory symptoms, a substantial number of patients eventually develop an acute cardiovascular syndrome associated with an excessive risk of mortality. While the exact mechanisms remain uncertain, angiotensin-converting enzyme 2 plays a pivotal role as a link between COVID-19 and the cardiovascular system. As there is no evidence that inhibition of the renin-angiotensin-aldosterone-system is harmful in COVID-19, therapy should be continued as indicated in hypertension or heart failure patients. As multiple drugs are being investigated in ongoing clinical trials, potential cardiotoxicity remains an important issue. In times of rigorous public health measures such as social distancing, efforts should be undertaken to ensure timely treatment of acute CVD and continuation of guideline-directed treatment in order to avoid an increase in morbidity and mortality. In addition to its acute complications, COVID-19 is likely to be associated with long-term cardiovascular damage. Consequently, for a subgroup of patients a long-term management strategy is needed.