JAMA Cardiology Review: COVID-19 and Potential Effects on the Heart & Vascular System

While intense efforts are well underway to discover and develop vaccines and antivirals against SARS-CoV-2, doctors are urged to control cardiovascular risk factors and conditions following evidence-based guidelines.

In an article published in the peer-reviewed journal JAMA Cardiology on Friday, March 27 2020, former Texas Heart Institute Senior Research Scientist and Cardiology Fellow Dr. Mohammed Madjid, currently an Assistant Professor of Medicine at McGovern Medical School at UTHealth, and Texas Heart Institute Research Associate Payam Safavi-Naeini provide an essential perspective on COVID-19 and its potential impact on prevention, diagnosis, and treatment of heart and vascular disease.

The article entitled “Potential Effects of Coronaviruses on the Cardiovascular System: A Review” chronicles cardiology relevant history of coronaviruses in the literature and details the basics of the seven coronaviruses— including COVID-19— along with their effects on the cardiovascular system.

“Coronaviruses are already known to affect the cardiovascular system, and although the extent, severity, and duration of cardiovascular effects of COVID-19 are still unclear, the previous influenza epidemics and SARS epidemic suggest that these viruses can trigger acute coronary syndromes, arrhythmias, and worsen heart failure,” said Dr. Madjid.

Typically, prior endemic strains of coronaviruses account for a small percentage of patients hospitalized for acute respiratory illness, according to the authors.  However, the new coronavirus (called SARS-CoV-2) acts differently.

The publication details the significant inflammatory response throughout the body that, combined with inflammation in the actual blood vessels where lipid-laden plaques reside, are among a handful of mechanisms compounding the problems caused by COVID-19.  Inflammation of the heart muscle (myocardium) is another potential mechanism.

“We agree with the proposed creation of a prospective registry of patients with COVID-19 that systematically records relevant clinical variables and cardiovascular complications. A registry is a critical initiative that we must launch immediately. Through a registry, we can identify patterns, develop important risk models for cardiac complications, and ultimately set the stage for proper identification and prediction to the responses to the various treatment modalities that we employ,” said Dr. Stephanie Coulter, Texas Heart Institute Assistant Medical Director.

As our understanding of COVID-19 is rapidly evolving, it is critically important for all members of the healthcare community to stay up to date with the situation on the US Centers for Disease Control and Prevention website and to follow the latest guidance from their professional societies carefully. 

Dr. Emerson Perin, Texas Heart Institute Medical Director, added, “In response to the evolving COVID-19 pandemic, THI is dedicating its online education series to providing timely perspectives to the health care community taking care of cardiovascular patients with COVID-19. Our invited panelists will discuss emerging strategies for preparing and taking care of all patients in facilities in which COVID patients are receiving treatments.”

Texas Heart Institute will launch the special online educational series, Cardiology In The Time of COVID-19, this week. Drs. Zvonimir Krajcer and Stephanie Coulter will interview the JAMA Cardiology review article authors, Dr. Mohammed Madgid and Payam Safavi-Naeini for the first episode.


Related Stories and Resources

Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. Published online March 27, 2020. doi:10.1001/jamacardio.2020.1286

ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)  (ACC)

HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19

HFSA/ACC/AHA statement addresses concerns re: using RAAS antagonists in COVID-19 (AHA)

New coronavirus can cause cardiovascular issues in serious cases, study shows (Houston Chronicle)

The Novel Coronavirus and its Impact on Global Security (Baker Institute at Rice University)

Coronavirus (COVID-19) Updates (TMC)

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