Comparison of cardiovascular metabolic characteristics and impact on COVID-19 and MERS,European Journal of Preventive Cardiology

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Comparison of cardiovascular metabolic characteristics and impact on COVID-19 and MERS
European Journal of Preventive Cardiology ( IF 8.3 ) Pub Date : 2020-05-18 , DOI: 10.1177/2047487320925218
Bo Li ₁ , Xiaodong Jin ₂ , Tongtong Zhang ₃ , Yan Zhao ₃ , Feng Tian ₄ , Yuhua Li ₅ , Jing Yang ₆ , Faming Zhao ₇ , Bin Li ₈

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Over the past decade, Middle East Respiratory Syndrome (MERS) coronavirus has emerged in the human population and accounted for a large number of deaths worldwide. In early December 2019, a series of pneumonia cases caused by SARS-CoV-2 emerged in Wuhan, Hubei, China, with the name of coronavirus disease 2019 (COVID-19). Both MERS-CoV and SARS-CoV-2 belong to the Coronavirus genus in the Coronaviridae family. MERS-CoV spread across Africa and East Asia from 2012 and had caused 1600 infections and 574 deaths by 2016, while SARS-CoV-2 has induced 81,099 infections with 3218 deaths in China and 91,216 infections with 3421 deaths outside of China as of 16 March 2020. Both SARSCoV-2 and MERS-CoV target the respiratory tract and share many similar clinical symptoms. Common symptoms include fever, fatigue and dry cough, followed always by anorexia, myalgia, dyspnoea and so on. Lymphopaenia and prolonged prothrombin time are also most common characteristics. Metabolic comorbidities were defined as the presence of one or more of the following conditions known to be associated with obesity: diabetes, hypertension, hypercholesterolaemia or cardiovascular disease. A systematic analysis of 637 MERS-CoV cases showed that diabetes and hypertension are prevalent in about 50% of the patients and cardiac diseases are present in 30% of the cases. With spread of SARS-CoV-2, more and more individuals exhibit comorbidities such as hypertension, diabetes and cardio-cerebrovascular disease. In Chen’s study of 99 cases, 40% of patients had cardiocerebrovascular disease, and in Huang’s study of 41 cases, 20% of patients had diabetes. These cardiovascular metabolic comorbidities might render them more susceptible to poor prognosis. The mechanisms by which coronavirus influences the cardiovascular system include: direct damage to cardiomyocytes by the virus, hypoxaemia and higher-level oxygen support, high concentration of inflammatory factors, repeated floods of catecholamines due to anxiety and the side effects of medication. In addition, studies found that patients with higher N-terminal pro-brain natriuretic peptide level and d-dimer greater than 1 lg/ml had more risk of death. COVID-19 can activate also coagulation cascade, leading to severe hypercoagulability and poor prognosis. Comparing the epidemiological characteristics of MERS and COVID-19 will be helpful for us to understand the characteristics of the novel coronavirus and to carry out targeted treatment. Prevalence of comorbidities including hypertension, diabetes and cardiovascular and cerebrovascular diseases in COVID-19 and MERS (Supplementary Material Tables 1 and 2 and Figure 1 online) together with clinical outcomes (intensive care unit (ICU) admission, death and cardiac injury) were

更新日期：2020-05-18

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