Cardiovascular Complications of COVID-19: Risk, Pathogenesis and Outcomes

Contents
1 The Epidemiology of CoViD19 and Cardiovascular Diseases
	1.1 Introduction
	1.2 Epidemiology
		1.2.1 Cardiovascular Disease or CoViD19, Which Comes First?
		1.2.2 The Burden of Cardiovascular Risk Factors in CoViD19
		1.2.3 Role of the Pre-existing Cardiovascular Diseases in CoViD19
		1.2.4 Critical CoViD19 Complications and Pre-existing Cardiovascular Disease
		1.2.5 Role of Cardiovascular Complications in CoViD19 Mortality
	1.3 Discussion
	1.4 Conclusion
	References
2 Virology of CoViD19
	2.1 Viral Characteristics
		2.1.1 Origins of SARS CoV2
		2.1.2 Hosts
		2.1.3 SARS CoV2 Structure
		2.1.4 SARS CoV2 Affinity and Infectivity
		2.1.5 SARS CoV2 Variability and Strains
	2.2 Mechanism of Viral Entry in Cells
		2.2.1 SARS CoV2 Viral Spike-ACE2 Signaling Mechanisms
		2.2.2 SARS COV, Cell Entry, and Receptors
		2.2.3 SARS CoV2 Similarities with SARS COV and MERS
		2.2.4 SARS CoV2, Cell Entry and Receptors
	2.3 Summary
	References
3 An Introduction to the Clinical and Diagnostic Features, and CoViD19 Complications
	3.1 Introduction
	3.2 Clinical Symptomatology
	3.3 Sepsis and Complications of CoViD19
	3.4 Important Diagnostic Features
		3.4.1 Viral Sampling
		3.4.2 Biochemical and Hematological Features
		3.4.3 Radiological Features
	3.5 Summary
	References
4 The Pathological Features of CoViD19 Cardiovascular Complications
	4.1 Introduction
	4.2 Key Features of Cardiovascular Pathology
		4.2.1 The Myocardial Injury in CoViD19
		4.2.2 Endomyocardial Biopsy and Myocarditis
		4.2.3 Endomyocardial Biopsy and Myocarditis with Viral Localization
		4.2.4 The Vascular Injury, Microvascular Cardiac Involvement, and Thromboembolic Features
		4.2.5 Endothelial Cell Infection and Apoptosis
	4.3 Summary
	References
5 Treatment Options in CoViD19
	5.1 Introduction
	5.2 Antiviral Agents in CoViD19
		5.2.1 Viral Cell Entry Inhibition and Viral Assembly Blockage
	5.3 Amino Quinolones in CoViD19
		5.3.1 Analysis of Body of Evidence on Amino Quinolones in CoViD19
	5.4 Immune-Based Therapies in CoViD19
		5.4.1 Immunomodulatory Agents
		5.4.2 Convalescent Plasma, and Antibody-Based Therapies
	5.5 Potential Anti-inflammatory Mechanisms
		5.5.1 NOD-Like Receptor Protein 3 (NLRP3)-Anti-inflammasomes
		5.5.2 Neutrophil Extracellular Traps (NETs)-Anti NETosis Therapy
	5.6 Anticoagulants
	5.7 CoViD19 Vaccines
	5.8 Summary
	References
6 An Introduction to the Pathogenetic Mechanisms of CoViD19 Complications
	6.1 Introduction
	6.2 Acute Pulmonary Injury
	6.3 Sepsis and Multi-organ Failure
	6.4 Renin Angiotensin System
	6.5 Endothelin System
	6.6 Immune-Inflammation
	6.7 Summary
	References
7 Overview of Cytokines and CoViD19
	7.1 Introduction
	7.2 Cytokines
		7.2.1 Interferon
		7.2.2 Interleukins
		7.2.3 Chemokines
		7.2.4 Colony Stimulating Factors
		7.2.5 Tumor Necrosis Factor
	7.3 Cytokine Storm in CoViD19
		7.3.1 Kinetics of the Cytokine Storm
		7.3.2 The “T” Cell Response
		7.3.3 Cytokines and Severity of CoViD19
	7.4 Cytokines in Cardiovascular and Metabolic Diseases
	7.5 Summary
	References
8 The Renin-Angiotensin System in COVID19
	8.1 Introduction
	8.2 The Renin Angiotensin System
		8.2.1 ACE2 Synthesis and Distribution
		8.2.2 ACE2 Expression
		8.2.3 ACE2 Detection
	8.3 The Dynamics of ACE2 Expression in CoViD19
		8.3.1 ACE2 Expression in Cardiovascular and Metabolic Conditions
		8.3.2 The Dynamics of ACE2 Expression and Cardiovascular Risk in CoViD19
		8.3.3 Age and Gender Variations of ACE2 and CoViD19
	8.4 ACE2 is a Marker of Severity or a Compensatory Mechanism?
	8.5 Summary
	References
9 Thrombosis in CoViD19
	9.1 Epidemiology
	9.2 Mechanisms Promoting Thrombosis in CoViD19
		9.2.1 Renin Angiotensin System and Thrombosis
		9.2.2 Endothelial Cell Damage and Thrombosis
		9.2.3 Inflammation and Thrombosis
		9.2.4 Microangiopathy and Thrombosis in CoViD19
		9.2.5 Platelets and Thrombosis in CoViD19
		9.2.6 D Dimers in CoViD19
		9.2.7 Hypoxia and Thrombosis
		9.2.8 Ethnic Disparities, High-Risk Subgroups and Coagulation
	9.3 Summary
	References
10 Pathogenesis of CoViD19—Miscellaneous Mechanisms
	10.1 Introduction
	10.2 Regulatory Peptide Systems in CoViD19
		10.2.1 Kallikrein-Kinin System
		10.2.2 Endothelin System
		10.2.3 Natriuretic Peptide System
	10.3 Miscellaneous Mechanisms
		10.3.1 Direct Viral Damage
		10.3.2 Endoplasmic Reticulum Stress
		10.3.3 Cell Death Modalities
		10.3.4 Mitochondrial Dysfunction
	10.4 Summary
	References
11 Myocardial Injury in CoViD19
	11.1 Introduction
	11.2 Epidemiology of Myocardial Injury
	11.3 Definition, Presentation, and Challenges of Myocardial Injury
	11.4 Timing and Assessment of Myocardial Injury
	11.5 Biomarkers of Myocardial Injury
	11.6 Pathogenesis of the Myocardial Injury
	11.7 Summary
	References
12 Heart Failure in CoViD19
	12.1 Epidemiology
	12.2 Role of Comorbidities in Heart Failure with CoViD19
	12.3 Biomarkers of Heart Failure in CoViD19
	12.4 Pathogenetic Mechanisms of Heart Failure in CoViD19
	12.5 Summary
	References
13 Hypertension in CoViD19
	13.1 Epidemiology
	13.2 Complexities in Hypertension and CoViD19
	13.3 CoViD19 Susceptibility and Hypertension
	13.4 Pathogenesis
	13.5 Summary
	References
14 Cardiac Arrhythmias in CoViD19
	14.1 Epidemiology of Arrhythmias in CoViD19
	14.2 Pathogenesis of Arrhythmias in CoViD19
	14.3 Summary
	References
15 Acute Coronary Syndromes in CoViD19
	15.1 Epidemiology of Acute Coronary Syndromes in CoViD19
	15.2 Defining Acute Coronary Syndromes, Challenges in Presentation and Assessment
	15.3 Pathogenesis of Acute Coronary Syndromes in CoViD19
	15.4 Summary
	References
16 Diabetes Mellitus and COVID19
	16.1 Epidemiology
	16.2 Pathogenesis
	16.3 Treatment Implications
	16.4 Summary
	References
17 Obesity and COVID19
	17.1 Introduction
	17.2 Pathogenetic Links – Obesity and CoViD19
	17.3 Summary
	References
18 The Older Age Adults and COVID19
	18.1 Epidemiology
		18.1.1 Oder Age and CoViD19 Criticality
		18.1.2 CoViD19 Fatality in Older Age Adults
		18.1.3 Older Age and Cardiovascular Disease in CoViD19
	18.2 CoViD19 Biomarkers in Older Adults
	18.3 Risk Mechanisms in Older Age and CoViD19
		18.3.1 Immune Dysfunction and Inflammation
		18.3.2 ACE2 Mechanisms
		18.3.3 Miscellaneous Age Related Mechanisms
	18.4 Summary
	References
19 Gender Disparity in CoViD19
	19.1 Epidemiology
	19.2 Discrepancies in the Epidemiological Data
	19.3 Factors Associated with Gender Dichotomy
	19.4 Gender Disparity in Immune Response
	19.5 Gender Disparity in ACE2 Mechanisms
	19.6 Gender Disparity in Cardiovascular Diseases
		19.6.1 Cardiovascular Pathogenetic Features and Gender
	19.7 Summary
	References
20 An Overview of Quality of Research in COVID19
	20.1 Introduction
	20.2 Quality Issues in CoViD19 Research and Improvement Initiatives
	20.3 Summary
	References
Index