COVID-19 and Cardiovascular Comorbidities

 

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Abstract

The emergence of a new coronavirus - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - has resulted in a global pandemic. The associated coronavirus disease 2019 (COVID-19) has resulted in a high number of death worldwide. Observational studies and case reports have provided insights that older age and the presence of chronic diseases is frequently associated with a higher COVID-19 severity. These individuals also seem to have a higher risk of mortality due to COVID-19. In this review we provide insights into the impact chronic diseases associated with the cardiovascular system, such as obesity, diabetes mellitus, hypertension and cardiovascular disease might have on SARS-CoV-2 infection and COVID-19. Additionally we review recommendations and guidance’s of international scientific associations and discuss which key learnings might be of importance for the future.

Publication History

Received: 07 September 2020
Received: 21 September 2020

Accepted: 23 September 2020

Article published online:
06 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

• References

• 1 World Health Organization. WHO coronavirus disease (COVID-19) dashboard. In. Geneva; 2020
  PubMed
• 2 Rizzo M, Foresti L, Montano N. Comparison of Reported Deaths From COVID-19 and Increase in Total Mortality in Italy. JAMA Internal Medicine 2020; DOI: 10.1001/jamainternmed.2020.2543.
  CrossrefPubMedGoogle Scholar
• 3 Mannucci E, Nreu B, Monami M. Factors associated with increased all-cause mortality during the COVID-19 pandemic in Italy. Int J Infect Dis 2020; DOI: 10.1016/j.ijid.2020.06.077.
  CrossrefPubMedGoogle Scholar
• 4 Vestergaard LS, Nielsen J, Richter L. et al. Excess all-cause mortality during the COVID-19 pandemic in Europe – preliminary pooled estimates from the EuroMOMO network, March to April 2020. Eurosurveillance 2020; 25 2001214 DOI: 10.2807/1560-7917.ES.2020.25.26.2001214.
  CrossrefPubMedGoogle Scholar
• 5 Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama 2020; DOI: 10.1001/jama.2020.2648.
  CrossrefPubMedGoogle Scholar
• 6 Böhm M, Frey N, Giannitsis E. et al. Coronavirus Disease 2019 (COVID-19) and its implications for cardiovascular care: expert document from the German Cardiac Society and the World Heart Federation. Clin Res Cardiol 2020; 1-14 DOI: 10.1007/s00392-020-01656-3.
  CrossrefPubMedGoogle Scholar
• 7 Varga Z, Flammer AJ, Steiger P. et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet 2020; 395: 1417-1418 DOI: 10.1016/S0140-6736(20)30937-5.
  CrossrefPubMedGoogle Scholar
• 8 Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 2017; 39: 529-539 10.1007/s00281-017-0629-x
  CrossrefPubMedGoogle Scholar
• 9 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England) 2020; 395: 497-506 DOI: 10.1016/s0140-6736(20)30183-5.
  CrossrefPubMedGoogle Scholar
• 10 Wang D, Hu B, Hu C. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama 2020; 323: 1061-1069 DOI: 10.1001/jama.2020.1585.
  CrossrefPubMedGoogle Scholar
• 11 Sama IE, Ravera A, Santema BT. et al. Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. European Heart Journal 2020; 41: 1810-1817 DOI: 10.1093/eurheartj/ehaa373.
  CrossrefPubMedGoogle Scholar
• 12 Williamson EJ, Walker AJ, Bhaskaran K. et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature 2020; DOI: 10.1038/s41586-020-2521-4.
  CrossrefPubMedGoogle Scholar
• 13 Dreher M, Kersten A, Bickenbach J. et al. The Characteristics of 50 Hospitalized COVID-19 Patients With and Without ARDS. Dtsch Arztebl International 2020; 117: 271-278 DOI: 10.3238/arztebl.2020.0271.
  CrossrefPubMedGoogle Scholar
• 14 Karagiannidis C, Mostert C, Hentschker C. et al. Case characteristics, resource use, and outcomes of 10021 patients with COVID-19 admitted to 920 German hospitals: an observational study. The Lancet. Respiratory Medicine 2020; DOI: 10.1016/S2213-2600(20)30316-7.
  CrossrefPubMedGoogle Scholar
• 15 Guo W, Li M, Dong Y. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes/metabolism research and reviews 2020; e3319 DOI: 10.1002/dmrr.3319.
  CrossrefPubMedGoogle Scholar
• 16 Caussy C, Pattou F, Wallet F. et al. Prevalence of obesity among adult inpatients with COVID-19 in France. The lancet Diabetes &. endocrinology 2020; 8: 562-564 DOI: 10.1016/s2213-8587(20)30160-1.
  CrossrefPubMedGoogle Scholar
• 17 Chen Q, Zheng Z, Zhang C. et al. Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Infection 2020; 1-9 DOI: 10.1007/s15010-020-01432-5.
  CrossrefPubMedGoogle Scholar
• 18 Mahase E. Covid-19: most patients require mechanical ventilation in first 24 h of critical care. BMJ (Clinical research ed) 2020; 368: m1201 10.1136/bmj.m1201
  PubMedGoogle Scholar
• 19 Bhatraju PK, Ghassemieh BJ, Nichols M. et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. New England Journal of Medicine 2020; 382: 2012-2022 DOI: 10.1056/NEJMoa2004500.
  CrossrefPubMedGoogle Scholar
• 20 Simonnet A, Chetboun M, Poissy J. et al. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring) 2020; 28: 1195-1199 DOI: 10.1002/oby.22831.
  CrossrefPubMedGoogle Scholar
• 21 Cai SH, Liao W, Chen SW. et al. Association between obesity and clinical prognosis in patients infected with SARS-CoV-2. Infect Dis Poverty 2020; 9: 80 DOI: 10.1186/s40249-020-00703-5.
  CrossrefPubMedGoogle Scholar
• 22 Lighter J, Phillips M, Hochman S. et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clin Infect Dis 2020; ciaa415 DOI: 10.1093/cid/ciaa415.
  CrossrefPubMedGoogle Scholar
• 23 Gao F, Zheng KI, Wang XB. et al. Obesity Is a Risk Factor for Greater COVID-19 Severity. Diabetes Care 2020; 43: e72-e74 DOI: 10.2337/dc20-0682.
  CrossrefPubMedGoogle Scholar
• 24 Pettit NN, MacKenzie EL, Ridgway J. et al. Obesity is Associated with Increased Risk for Mortality Among Hospitalized Patients with COVID-19. Obesity (Silver Spring) 2020; DOI: 10.1002/oby.22941.
  CrossrefPubMedGoogle Scholar
• 25 Alberca RW, Oliveira LM, Branco A. et al. Obesity as a risk factor for COVID-19: an overview. Crit Rev Food Sci Nutr 2020; 1-15 DOI: 10.1080/10408398.2020.1775546.
  CrossrefPubMedGoogle Scholar
• 26 Han JM, Patterson SJ, Speck M. et al. Insulin inhibits IL-10-mediated regulatory T cell function: implications for obesity. J Immunol 2014; 192: 623-629 DOI: 10.4049/jimmunol.1302181.
  CrossrefPubMedGoogle Scholar
• 27 Andersen CJ, Murphy KE, Fernandez ML. Impact of Obesity and Metabolic Syndrome on Immunity. Advances in nutrition (Bethesda, Md) 2016; 7: 66-75 10.3945/an.115.010207
  CrossrefPubMedGoogle Scholar
• 28 Wang T, Du Z, Zhu F. et al. Comorbidities and multi-organ injuries in the treatment of COVID-19. Lancet (London, England) 2020; 395: e52 DOI: 10.1016/s0140-6736(20)30558-4.
  CrossrefPubMedGoogle Scholar
• 29 Yang X, Yu Y, Xu J. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. The Lancet Respiratory Medicine 2020; 8: 475-481 DOI: 10.1016/S2213-2600(20)30079-5.
  CrossrefPubMedGoogle Scholar
• 30 Guan W-j, Ni Z-y, Hu Y. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine 2020; 382: 1708-1720 DOI: 10.1056/NEJMoa2002032.
  CrossrefPubMedGoogle Scholar
• 31 Zhang J-j, Dong X, Cao Y-y et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020; DOI: 10.1111/all.14238
  PubMed
• 32 Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018; 12: 755-767 10.1080/17476348.2018.1506331
  CrossrefPubMedGoogle Scholar
• 33 Chiappetta S, Sharma AM, Bottino V. et al. COVID-19 and the role of chronic inflammation in patients with obesity. Int J Obes (Lond) 2020; 1-3 DOI: 10.1038/s41366-020-0597-4.
  CrossrefPubMedGoogle Scholar
• 34 Selim BJ, Ramar K, Surani S. Obesity in the intensive care unit: risks and complications. Hosp Pract (1995) 2016; 44: 146-156 10.1080/21548331.2016.1179558
  CrossrefPubMedGoogle Scholar
• 35 Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic. Acta Diabetologica 2020; 57: 759-764 10.1007/s00592-020-01522-8
  CrossrefPubMedGoogle Scholar
• 36 Frühbeck G, Baker JL, Busetto L. et al. European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic. Obesity Facts 2020; 13: 292-296 DOI: 10.1159/000508082.
  CrossrefPubMedGoogle Scholar
• 37 Li B, Yang J, Zhao F. et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol 2020; 109: 531-538 DOI: 10.1007/s00392-020-01626-9.
  CrossrefPubMedGoogle Scholar
• 38 Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. Jama 2020; 323: 1775-1776 10.1001/jama.2020.4683
  PubMedGoogle Scholar
• 39 Wu C, Chen X, Cai Y. et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA internal medicine 2020; e200994 DOI: 10.1001/jamainternmed.2020.0994.
  CrossrefPubMedGoogle Scholar
• 40 Yan Y, Yang Y, Wang F. et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ open diabetes research & care 2020; 8 DOI: 10.1136/bmjdrc-2020-001343.
  CrossrefPubMedGoogle Scholar
• 41 Roncon L, Zuin M, Rigatelli G. et al. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J Clin Virol 2020; 127: 104354 DOI: 10.1016/j.jcv.2020.104354.
  CrossrefPubMedGoogle Scholar
• 42 Chung SM, Lee YY, Ha E. et al. The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study. Diabetes Metab J 2020; 44: 405-413 DOI: 10.4093/dmj.2020.0105.
  CrossrefPubMedGoogle Scholar
• 43 Fadini GP, Morieri ML, Longato E. et al. Prevalence and impact of diabetes among people infected with SARS-CoV-2. Journal of Endocrinological Investigation 2020; 43: 867-869 DOI: 10.1007/s40618-020-01236-2.
  CrossrefPubMedGoogle Scholar
• 44 Mantovani A, Byrne CD, Zheng MH. et al. Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: A meta-analysis of observational studies. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD 2020; DOI: 10.1016/j.numecd.2020.05.014.
  CrossrefPubMedGoogle Scholar
• 45 Wu ZH, Tang Y, Cheng Q. Diabetes increases the mortality of patients with COVID-19: a meta-analysis. Acta Diabetologica 2020; 1-6 10.1007/s00592-020-01546-0
  PubMedGoogle Scholar
• 46 Wu J, Zhang J, Sun X. et al. Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection. Diabetes, Obesity & Metabolism 2020; DOI: 10.1111/dom.14105.
  CrossrefPubMedGoogle Scholar
• 47 Zhu L, She ZG, Cheng X. et al. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metabolism 2020; DOI: 10.1016/j.cmet.2020.04.021.
  CrossrefPubMedGoogle Scholar
• 48 Wang L, Gao P, Zhang M. et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. Jama 2017; 317: 2515-2523 DOI: 10.1001/jama.2017.7596.
  CrossrefPubMedGoogle Scholar
• 49 Bode B, Garrett V, Messler J. et al. Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States. J Diabetes Sci Technol 2020; 1932296820924469 DOI: 10.1177/1932296820924469.
  CrossrefPubMedGoogle Scholar
• 50 Li H, Tian S, Chen T. et al. Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID-19. Diabetes, Obesity &. Metabolism 2020; DOI: 10.1111/dom.14099.
  CrossrefPubMedGoogle Scholar
• 51 Cariou B, Hadjadj S, Wargny M. et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia 2020; 1-16 DOI: 10.1007/s00125-020-05180-x.
  CrossrefPubMedGoogle Scholar
• 52 Coppelli A, Giannarelli R, Aragona M. et al. Hyperglycemia at Hospital Admission Is Associated With Severity of the Prognosis in Patients Hospitalized for COVID-19: The Pisa COVID-19 Study. Diabetes Care 2020; dc201380 DOI: 10.2337/dc20-1380.
  CrossrefPubMedGoogle Scholar
• 53 Singh AK, Singh R. At-admission hyperglycemia is consistently associated with poor prognosis and early intervention can improve outcomes in patients with COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020; DOI: 10.1016/j.dsx.2020.08.034.
  CrossrefPubMedGoogle Scholar
• 54 Zhou J, Tan J. Diabetes patients with COVID-19 need better blood glucose management in Wuhan, China. Metabolism: Clinical and Experimental 2020; 107: 154216 10.1016/j.metabol.2020.154216
  CrossrefPubMedGoogle Scholar
• 55 Allard R, Leclerc P, Tremblay C. et al. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care 2010; 33: 1491-1493 DOI: 10.2337/dc09-2215.
  CrossrefPubMedGoogle Scholar
• 56 Booth CM, Matukas LM, Tomlinson GA. et al. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. Jama 2003; 289: 2801-2809 DOI: 10.1001/jama.289.21.JOC30885.
  CrossrefPubMedGoogle Scholar
• 57 Yang JK, Feng Y, Yuan MY. et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med 2006; 23: 623-628 DOI: 10.1111/j.1464-5491.2006.01861.x.
  CrossrefPubMedGoogle Scholar
• 58 Nassar MS, Bakhrebah MA, Meo SA. et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: epidemiology, pathogenesis and clinical characteristics. Eur Rev Med Pharmacol Sci 2018; 22: 4956-4961 DOI: 10.26355/eurrev_201808_15635.
  CrossrefPubMedGoogle Scholar
• 59 Ilyas R, Wallis R, Soilleux EJ. et al. High glucose disrupts oligosaccharide recognition function via competitive inhibition: a potential mechanism for immune dysregulation in diabetes mellitus. Immunobiology 2011; 216: 126-131 DOI: 10.1016/j.imbio.2010.06.002.
  CrossrefPubMedGoogle Scholar
• 60 Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999; 26: 259-265 10.1111/j.1574-695X.1999.tb01397.x
  CrossrefPubMedGoogle Scholar
• 61 Pearson-Stuttard J, Blundell S, Harris T. et al. Diabetes and infection: assessing the association with glycaemic control in population-based studies. The lancet Diabetes & endocrinology 2016; 4: 148-158 DOI: 10.1016/s2213-8587(15)00379-4.
  CrossrefPubMedGoogle Scholar
• 62 Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice 2020; 162: 108142-108142 10.1016/j.diabres.2020.108142
  CrossrefPubMedGoogle Scholar
• 63 Yang JK, Lin SS, Ji XJ. et al. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetologica 2010; 47: 193-199 DOI: 10.1007/s00592-009-0109-4.
  CrossrefPubMedGoogle Scholar
• 64 Brufsky A. Hyperglycemia, hydroxychloroquine, and the COVID-19 pandemic. J Med Virol 2020; DOI: 10.1002/jmv.25887.
  CrossrefPubMedGoogle Scholar
• 65 Bornstein SR, Dalan R, Hopkins D. et al. Endocrine and metabolic link to coronavirus infection. Nature Reviews. Endocrinology 2020; 16: 297-298 DOI: 10.1038/s41574-020-0353-9.
  CrossrefPubMedGoogle Scholar
• 66 Pal R, Bhadada SK. COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes & Metabolic Syndrome 2020; 14: 513-517 10.1016/j.dsx.2020.04.049
  CrossrefPubMedGoogle Scholar
• 67 Kumar V, Singh MP, Singh AP. et al. Efficacy and safety of hydroxychloroquine when added to stable insulin therapy in combination with metformin and glimepiride in patients with type 2 diabetes compare to sitagliptin 2018. 2018; 7: 6 DOI: 10.18203/2319-2003.ijbcp20183930.
  CrossrefPubMedGoogle Scholar
• 68 Singh AK, Gupta R, Ghosh A. et al. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & Metabolic Syndrome 2020; 14: 303-310 DOI: 10.1016/j.dsx.2020.04.004.
  CrossrefPubMedGoogle Scholar
• 69 Drucker DJ. Coronavirus Infections and Type 2 Diabetes-Shared Pathways with Therapeutic Implications. Endocrine reviews 2020; 41 : DOI: 10.1210/endrev/bnaa011
  PubMedGoogle Scholar
• 70 Pal R, Bhadada SK. Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?. Diabetes Research and Clinical Practice 2020; 163: 108146 https://doi.org/10.1016/j.diabres.2020.108146
  CrossrefPubMedGoogle Scholar
• 71 Song Z, Xu Y, Bao L. et al. From SARS to MERS, Thrusting Coronaviruses into the Spotlight. Viruses 2019; 11 DOI: 10.3390/v11010059.
  CrossrefPubMedGoogle Scholar
• 72 Chen Y, Yang D, Cheng B. et al. Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication. Diabetes Care 2020; 43: 1399-1407 DOI: 10.2337/dc20-0660.
  CrossrefPubMedGoogle Scholar
• 73 Apicella M, Campopiano MC, Mantuano M. et al. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The lancet Diabetes & Endocrinology 2020; DOI: 10.1016/s2213-8587(20)30238-2.
  CrossrefPubMedGoogle Scholar
• 74 Katulanda P, Dissanayake HA, Ranathunga I. et al. Prevention and management of COVID-19 among patients with diabetes: An appraisal of the literature. Diabetologia 2020; 63: 1440-1452 DOI: 10.1007/s00125-020-05164-x.
  CrossrefPubMedGoogle Scholar
• 75 Bhimraj A, Morgan RL, Shumaker AH. et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis 2020; DOI: 10.1093/cid/ciaa478.
  CrossrefPubMedGoogle Scholar
• 76 Deutsche Diabetes Gesellschaft. Praktische Empfehlungen zum Diabetes-Management bei Patientinnen und Patienten mit einer COVID-19-Erkrankung. In; 2020
  PubMed
• 77 Bornstein SR, Rubino F, Khunti K. et al. Practical recommendations for the management of diabetes in patients with COVID-19. The Lancet Diabetes &. Endocrinology 2020; 8: 546-550 DOI: 10.1016/S2213-8587(20)30152-2.
  CrossrefPubMedGoogle Scholar
• 78 Ceriello A, Standl E, Catrinoiu D. et al. Issues of Cardiovascular Risk Management in People With Diabetes in the COVID-19 Era. Diabetes Care 2020; dc200941 DOI: 10.2337/dc20-0941.
  CrossrefPubMedGoogle Scholar
• 79 Hartmann-Boyce J, Morris E, Goyder C. et al. Diabetes and COVID-19: Risks, Management, and Learnings From Other National Disasters. Diabetes Care 2020; dc201192 DOI: 10.2337/dc20-1192.
  CrossrefPubMedGoogle Scholar
• 80 Tadic M, Cuspidi C, Grassi G. et al. COVID-19 and arterial hypertension: Hypothesis or evidence?. J Clin Hypertens (Greenwich) 2020; DOI: 10.1111/jch.13925.
  CrossrefPubMedGoogle Scholar
• 81 Gao Y, Chen G, Tian H. et al. Prevalence of hypertension in china: a cross-sectional study. PloS one 2013; 8: e65938-e65938 DOI: 10.1371/journal.pone.0065938.
  CrossrefPubMedGoogle Scholar
• 82 Tocci G, Nati G, Cricelli C. et al. Prevalence and control of hypertension in the general practice in Italy: updated analysis of a large database. J Hum Hypertens 2017; 31: 258-262 DOI: 10.1038/jhh.2016.71.
  CrossrefPubMedGoogle Scholar
• 83 Zhang J, Wu J, Sun X. et al. Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis. Epidemiol Infect 2020; 148: e106 DOI: 10.1017/s095026882000117x.
  CrossrefPubMedGoogle Scholar
• 84 Huang S, Wang J, Liu F. et al. COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study. Hypertension Research : Official Journal of the Japanese Society of Hypertension. 2020; 1-8 DOI: 10.1038/s41440-020-0485-2.
  CrossrefPubMedGoogle Scholar
• 85 Yanai H. A Significance of High Prevalence of Diabetes and Hypertension in Severe COVID-19 Patients. J Clin Med Res 2020; 12: 389-392 10.14740/jocmr4218
  CrossrefPubMedGoogle Scholar
• 86 Pranata R, Lim MA, Huang I. et al. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. Journal of the renin-angiotensin-aldosterone system : JRAAS 2020; 21 1470320320926899 DOI: 10.1177/1470320320926899.
  CrossrefPubMedGoogle Scholar
• 87 Yang Q, Zhou Y, Wang X. et al. Effect of hypertension on outcomes of adult inpatients with COVID-19 in Wuhan, China: A propensity score-matching analysis. Respir Res 2020; 21: 172 DOI: 10.1186/s12931-020-01435-8.
  CrossrefPubMedGoogle Scholar
• 88 Nandy K, Salunke A, Pathak SK. et al. Coronavirus disease (COVID-19): A systematic review and meta-analysis to evaluate the impact of various comorbidities on serious events. Diabetes & Metabolic Syndrome 2020; 14: 1017-1025 DOI: 10.1016/j.dsx.2020.06.064.
  CrossrefPubMedGoogle Scholar
• 89 Parveen R, Sehar N, Bajpai R. et al. Association of diabetes and hypertension with disease severity in covid-19 patients: a systematic literature review and exploratory meta-analysis. Diabetes Research and Clinical Practice 2020; 108295 DOI: 10.1016/j.diabres.2020.108295.
  CrossrefPubMedGoogle Scholar
• 90 Singh AK, Gupta R, Misra A. Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes & Metabolic Syndrome 2020; 14: 283-287 10.1016/j.dsx.2020.03.016
  CrossrefPubMedGoogle Scholar
• 91 Kulkarni S, Jenner BL, Wilkinson I. COVID-19 and hypertension. Journal of the renin-angiotensin-aldosterone system : JRAAS 2020; 21: 1470320320927851 10.1177/1470320320927851
  CrossrefPubMedGoogle Scholar
• 92 Gao C, Cai Y, Zhang K. et al. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. European heart journal 2020; 41: 2058-2066 DOI: 10.1093/eurheartj/ehaa433.
  CrossrefPubMedGoogle Scholar
• 93 Harrison DG, Guzik TJ, Lob HE. et al. Inflammation, immunity, and hypertension. Hypertension (Dallas, Tex : 1979) 2011; 57: 132-140 DOI: 10.1161/HYPERTENSIONAHA.110.163576.
  CrossrefPubMedGoogle Scholar
• 94 De Miguel C, Rudemiller NP, Abais JM. et al. Inflammation and hypertension: new understandings and potential therapeutic targets. Current hypertension reports 2015; 17: 507-507 DOI: 10.1007/s11906-014-0507-z.
  CrossrefPubMedGoogle Scholar
• 95 Perrotta M, Lori A, Carnevale L. et al. Deoxycorticosterone acetate-salt hypertension activates placental growth factor in the spleen to couple sympathetic drive and immune system activation. Cardiovascular Research 2018; 114: 456-467 DOI: 10.1093/cvr/cvy001.
  CrossrefPubMedGoogle Scholar
• 96 Chou CH, Hung CS, Liao CW. et al. IL-6 trans-signalling contributes to aldosterone-induced cardiac fibrosis. Cardiovascular Research 2018; 114: 690-702 DOI: 10.1093/cvr/cvy013.
  CrossrefPubMedGoogle Scholar
• 97 Hanff TC, Harhay MO, Brown TS. et al. Is There an Association Between COVID-19 Mortality and the Renin-Angiotensin System-a Call for Epidemiologic Investigations. Clin Infect Dis 2020; DOI: 10.1093/cid/ciaa329.
  CrossrefPubMedGoogle Scholar
• 98 Zhang P, Zhu L, Cai J. et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circulation Research 2020; 126: 1671-1681 DOI: 10.1161/CIRCRESAHA.120.317134.
  CrossrefPubMedGoogle Scholar
• 99 European Society of Hypertension. Statement of the European Society of Hypertension (ESH) on hypertension, Renin-Angiotensin System(RAS) blockers and COVID-19. In; 2020
  PubMed
• 100 Kreutz R, Algharably EAE, Azizi M. et al. Hypertension, the renin-angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19. Cardiovascular Research 2020; DOI: 10.1093/cvr/cvaa097.
  CrossrefPubMedGoogle Scholar
• 101 Heart Failure Society of America, American College of Cardiology, American Heart Association. HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. 2020:
  PubMed
• 102 European Society of Cardiology. Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers 2020:
  PubMed
• 103 Deutsche Gesellschaft für Kardiologie. COVID-19 und Behandlung mit Hemmstoffen des Renin-Angiotensin-Systems. In; 2020
  PubMed
• 104 World Hypertension League. COVID-19 hypertension guidance. In; 2020
  PubMed
• 105 Guo T, Fan Y, Chen M. et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA cardiology 2020; 5: 1-8 DOI: 10.1001/jamacardio.2020.1017.
  CrossrefPubMedGoogle Scholar
• 106 Aggarwal G, Cheruiyot I, Aggarwal S. et al. Association of Cardiovascular Disease With Coronavirus Disease 2019 (COVID-19) Severity: A Meta-Analysis. Curr Probl Cardiol 2020; 45: 100617-100617 DOI: 10.1016/j.cpcardiol.2020.100617.
  CrossrefPubMedGoogle Scholar
• 107 Zhou F, Yu T, Du R. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 2020; 395: 1054-1062 DOI: 10.1016/S0140-6736(20)30566-3.
  CrossrefPubMedGoogle Scholar
• 108 Ruan Q, Yang K, Wang W. et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine 2020; 46: 846-848 DOI: 10.1007/s00134-020-05991-x.
  CrossrefPubMedGoogle Scholar
• 109 Li X, Guan B, Su T. et al. Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis. Heart (British Cardiac Society) 2020; 106: 1142 DOI: 10.1136/heartjnl-2020-317062.
  CrossrefPubMedGoogle Scholar
• 110 Zhang J, Lu S, Wang X. et al. Do underlying cardiovascular diseases have any impact on hospitalised patients with COVID-19?. Heart (British Cardiac Society) 2020; 106: 1148-1153 DOI: 10.1136/heartjnl-2020-316909.
  CrossrefPubMedGoogle Scholar
• 111 Xu Z, Shi L, Wang Y. et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine 2020; 8: 420-422 DOI: 10.1016/S2213-2600(20)30076-X.
  CrossrefPubMedGoogle Scholar
• 112 Inciardi RM, Lupi L, Zaccone G. et al. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). JAMA cardiology 2020; 5: 819-824 DOI: 10.1001/jamacardio.2020.1096.
  CrossrefPubMedGoogle Scholar
• 113 Shi S, Qin M, Shen B. et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan. China. JAMA cardiology 2020; DOI: 10.1001/jamacardio.2020.0950.
  CrossrefPubMedGoogle Scholar
• 114 Zheng Y-Y, Ma Y-T, Zhang J-Y. et al. COVID-19 and the cardiovascular system. Nature Reviews. Cardiology 2020; 17: 259-260 DOI: 10.1038/s41569-020-0360-5.
  CrossrefPubMedGoogle Scholar
• 115 Madjid M, Safavi-Naeini P, Solomon SD. et al. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA cardiology 2020; DOI: 10.1001/jamacardio.2020.1286.
  CrossrefPubMedGoogle Scholar
• 116 Lindner D, Fitzek A, Bräuninger H. et al. Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. JAMA cardiology 2020; DOI: 10.1001/jamacardio.2020.3551.
  CrossrefPubMedGoogle Scholar
• 117 Cooper LT. Myocarditis. New England Journal of Medicine 2009; 360: 1526-1538 10.1056/NEJMra0800028
  CrossrefPubMedGoogle Scholar
• 118 Lala A, Johnson KW, Januzzi JL. et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. J Am Coll Cardiol 2020; 76: 533-546 DOI: 10.1016/j.jacc.2020.06.007.
  CrossrefPubMedGoogle Scholar
• 119 Xiong T-Y, Redwood S, Prendergast B. et al. Coronaviruses and the cardiovascular system: acute and long-term implications. European Heart Journal 2020; 41: 1798-1800 DOI: 10.1093/eurheartj/ehaa231.
  CrossrefPubMedGoogle Scholar
• 120 Rowland B, Kunadian V. Challenges in the management of older patients with acute coronary syndromes in the COVID-19 pandemic. Heart (British Cardiac Society) 2020; heartjnl-2020-317011 DOI: DOI: 10.1136/heartjnl-2020-317011.
  CrossrefPubMedGoogle Scholar
• 121 Wu Q, Zhou L, Sun X. et al. Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection. Sci Rep 2017; 7: 9110 DOI: 10.1038/s41598-017-09536-z.
  CrossrefPubMedGoogle Scholar
• 122 European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. In; 2020
  PubMed
• 123 Han Y, Zeng H, Jiang H. et al. CSC Expert Consensus on Principles of Clinical Management of Patients With Severe Emergent Cardiovascular Diseases During the COVID-19 Epidemic. Circulation 2020; 141: e810-e816 DOI: 10.1161/CIRCULATIONAHA.120.047011.
  CrossrefPubMedGoogle Scholar
• 124 American Heart Association. Coronavirus (COVID-19). In; 2020
  PubMed
• 125 American College of Cardiology. COVID-19 Clinical Guidance for Global Cardiovascular Clinicians. In; 2020
  PubMed
• 126 Zaman S, MacIsaac AI, Jennings GL. et al. Cardiovascular disease and COVID-19: Australian and New Zealand consensus statement. The. Medical journal of Australia 2020; DOI: 10.5694/mja2.50714.
  CrossrefPubMedGoogle Scholar
• 127 Deutsche Gesellschaft für Kardiologie. Notfallversorgung von Patienten mit akuten Herzerkrankungen während der Corona-Pandemie. In; 2020
  PubMed
• 128 Fragala MHWK, Meigs J. et al. Consequences of the COVID-19 Pandemic: Reduced Hemoglobin A1c Diabetes Monitoring. Population Health Management 2020; DOI: 10.1089/pop.2020.0134.
  CrossrefPubMedGoogle Scholar
• 129 Karter AJ, Parker MM, Moffet HH. et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Medical Care 2004; 42: 110-115 DOI: 10.1097/01.mlr.0000109023.64650.73.
  CrossrefPubMedGoogle Scholar
• 130 Samuels TA, Bolen S, Yeh HC. et al. Missed opportunities in diabetes management: a longitudinal assessment of factors associated with sub-optimal quality. J Gen Intern Med 2008; 23: 1770-1777 DOI: 10.1007/s11606-008-0757-z.
  CrossrefPubMedGoogle Scholar
• 131 Bonora BM, Boscari F, Avogaro A. et al. Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy. Diabetes Ther 2020; 1-11 DOI: 10.1007/s13300-020-00829-7.
  CrossrefPubMedGoogle Scholar
• 132 Capaldo B, Annuzzi G, Creanza A. et al. Blood Glucose Control During Lockdown for COVID-19: CGM Metrics in Italian Adults With Type 1 Diabetes. Diabetes Care 2020; DOI: 10.2337/dc20-1127.
  CrossrefPubMedGoogle Scholar
• 133 Maddaloni E, Coraggio L, Pieralice S. et al. Effects of COVID-19 Lockdown on Glucose Control: Continuous Glucose Monitoring Data From People With Diabetes on Intensive Insulin Therapy. Diabetes Care 2020; 43: e86-e87 DOI: 10.2337/dc20-0954.
  CrossrefPubMedGoogle Scholar
• 134 Baum A, Schwartz MD. Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic. Jama 2020; 324: 96-99 10.1001/jama.2020.9972
  CrossrefPubMedGoogle Scholar
• 135 Lazzerini M, Barbi E, Apicella A. et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. The Lancet Child & Adolescent Health 2020; 4: e10-e11 DOI: 10.1016/S2352-4642(20)30108-5.
  CrossrefPubMedGoogle Scholar
• 136 Slagman A, Behringer W, Greiner F. et al. Medical Emergencies During the COVID-19 Pandemic. Dtsch Arztebl International 2020; 117: 545-552 DOI: 10.3238/arztebl.2020.0545.
  CrossrefPubMedGoogle Scholar
• 137 Kamrath C, Mönkemöller K, Biester T. et al. Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany. Jama 2020; DOI: 10.1001/jama.2020.13445.
  CrossrefPubMedGoogle Scholar
• 138 Garcia S, Albaghdadi MS, Meraj PM. et al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. Journal of the American College of Cardiology 2020; 75: 2871-2872 DOI: 10.1016/j.jacc.2020.04.011.
  CrossrefPubMedGoogle Scholar
• 139 Solomon MD, McNulty EJ, Rana JS. et al. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. New England Journal of Medicine 2020; DOI: 10.1056/NEJMc2015630.
  CrossrefPubMedGoogle Scholar
• 140 De Filippo O, D’Ascenzo F, Angelini F. et al. Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy. The. New England Journal of Medicine 2020; 383: 88-89 DOI: 10.1056/NEJMc2009166.
  CrossrefPubMedGoogle Scholar
• 141 Marijon E, Karam N, Jost D. et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. The Lancet Public Health 2020; DOI: 10.1016/S2468-2667(20)30117-1.
  CrossrefPubMedGoogle Scholar
• 142 Puntmann VO, Carerj ML, Wieters I. et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiology 2020; DOI: 10.1001/jamacardio.2020.3557.
  CrossrefPubMedGoogle Scholar
• 143 Pierce M, Hope H, Ford T. et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. The Lancet Psychiatry 2020; DOI: 10.1016/S2215-0366(20)30308-4.
  CrossrefPubMedGoogle Scholar
• 144 Bhaskar S, Rastogi A, Chattu VK. et al. Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. Frontiers in Cardiovascular Medicine 2020; 7: 112 DOI: 10.3389/fcvm.2020.00112.
  CrossrefPubMedGoogle Scholar
• 145 Chudasama YV, Gillies CL, Zaccardi F. et al. Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals. Diabetes & metabolic syndrome 2020; 14: 965-967 DOI: 10.1016/j.dsx.2020.06.042.
  CrossrefPubMedGoogle Scholar
• 146 Emerging Infections Task Force. Lean European Open Survey on SARS-CoV-2 infected patients” (LEOSS) database and research platform In; 2020
  PubMed