A CHANGE IN HEART: A REVIEW OF THE EFFECTS OF SARS-COV-2 ON THE CARDIOVASCULAR SYSTEM

Abstract

Within months of its first appearance in Wuhan, China, the COVID-19 virus, referred to as SARS-CoV-2, had spread across the globe, infecting hundreds of millions of individuals. SARSCoV-2, one of many viruses in the severe acute respiratory syndrome coronavirus family, is known to cause a variety of flu-like symptoms including fever, coughing, and shortness of breath. For many patients with pre-existing conditions, particularly those with previous cardiovascular conditions, COVID-19 infection is often more severe and may lead to hospitalization. This review aims to explore these pathological effects of the SARS-CoV-2 virus on the cardiovascular system. We will begin by covering an overview of the cardiovascular system and blood pressure regulation. We will then explore the interaction between SARS-CoV-2 and the renin-angiotensin-aldosterone system (RAAS), which is responsible for producing changes in blood pressure within the body. SARS-CoV-2 binds to ACE2, one of the receptors in the ACE2-Ang(1-7)-Mas axis of RAAS. It is thought that this downregulation in the surface expression of ACE2—due to viral uptake—contributes to the cardiovascular complications experienced by high-risk patients. This review will then shift to the effects of COVID-19 on specific cardiovascular conditions including hypertension, heart failure, and atherosclerosis. Finally, we will conclude with an assessment of the current research regarding continued usage of ACE inhibitors and ARBS in patients with COVID-19.