Cardiovascular and renal risk factors and complications associated with COVID-19

Touyz, R. M. et al. (2021) Cardiovascular and renal risk factors and complications associated with COVID-19. CJC Open, 3(10), pp. 1257-1272. (doi: 10.1016/j.cjco.2021.05.020) (PMID:34151246) (PMCID:PMC8205551)

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Abstract

The current COVID-19 pandemic, caused by the SARS-CoV-2 virus (Severe Acute Respiratory Syndrome-Coronavirus-2), represents the largest medical challenge in decades. It has exposed unexpected cardiovascular vulnerabilities at all stages of the disease (pre-infection, acute phase and subsequent chronic phase). The major cardiometabolic drivers identified to have epidemiological and mechanistic associations with COVID-19 are abnormal adiposity, dysglycemia, dyslipidemia, and hypertension. Hypertension is of particular interest, because components of the renin-angiotensin system (RAS), which are critically involved in the pathophysiology of hypertension, are also implicated in COVID-19. Specifically ACE2, a multifunctional protein of the RAS, which is part of the protective axis of the RAS, is also the receptor through which SARS-CoV-2 enters host cells causing viral infection. Cardiovascular and cardiometabolic co-morbidities not only predispose to COVID-19, but are complications of SARS-CoV-2 infection. In addition, increasing evidence indicates that acute kidney injury is common in COVID-19, that it occurs early and in temporal association with respiratory failure and is associated with poor prognosis, especially in the presence of cardiovascular risk factors. Here we discuss cardiovascular and kidney disease in the context of COVID-19 and provide recent advances on putative pathophysiological mechanisms linking cardiovascular disease and COVID-19, focusing on the RAS and ACE2 as well as the immune system and inflammation. We provide up-to-date information on the relationship between hypertension, diabetes, and COVID-19 and emphasize the major cardiovascular diseases associated with COVID-19. We also briefly discuss emerging cardiovascular complications associated with long COVID-19, notably postural tachycardia syndrome (POTS).

Item Type:Articles
Keywords:SARS-CoV-2, ACE2, hypertension, myocarditis thromboembolic disease, kidney disease, diabetes, cardiovascular risk, long COVID-19.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Rios, Dr Francisco and Padmanabhan, Professor Sandosh and Mark, Professor Patrick and Delles, Professor Christian and Petrie, Professor John and Guzik, Professor Tomasz and Montezano, Dr Augusto and Sykes, Dr Robert and McCallum, Dr Linsay and Touyz, Professor Rhian
Authors: Touyz, R. M., Boyd, M. O.E., Guzik, T., Padmanabhan, S., McCallum, L., Delles, C., Mark, P. B., Petrie, J. R., Rios, F., Montezano, A. C., Sykes, R., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:CJC Open
Publisher:Elsevier
ISSN:2589-790X
ISSN (Online):2589-790X
Published Online:16 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in CJC Open 3(10): 1257-1272
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
300689Vascular Noxs as therapeutic targets and biomarkers in hypertensionRhian TouyzBritish Heart Foundation (BHF)CH/12/4/29762CAMS - Cardiovascular Science
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science
301454CORonary MICrovascular Angina (CorMicA): a pilot trial with a nested MRI sub-studyColin BerryBritish Heart Foundation (BHF)PG/17/25/32884CAMS - Cardiovascular Science
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences
167816Genetic, molecular and functional dissection of a novel pathway for hypertension: Uromodulin, renal function, sodium homeostasis and blood pressure.Sandosh PadmanabhanBritish Heart Foundation (BHF)PG/12/85/29925Institute of Cardiovascular & Medical Sciences
173522Clinical study of UMOD NKCC2 interaction on salt-sensitivity in hypertensionSandosh PadmanabhanBritish Heart Foundation (BHF)CS/16/1/31878Institute of Cardiovascular & Medical Sciences
311300CSO covid 19 portfolioIain McInnesOffice of the Chief Scientific Adviser (CSO)COV/GLA/PortfolioIII - Immunology