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Current options for addressing cardiovascular complications of COVID-19. Although COVID-19 commonly presents as a respiratory infection, the illness targets multiple organ systems, including the cardiovascular system. In one study, patients with cardiac injury accounted for nearly one-fourth of severe cases of COVID-19. A recent article describes the inflammatory aspects of COVID-19, identifies current therapies used in regard to cardiac injury, and suggests guidelines for clinical practice.

The authors of the article identify three primary drivers of cardiac injury in COVID-19: direct viral infection to cardiac tissues, cytokine storm, and aggravation of preexisting cardiovascular disease. They posited that direct infection of cardiac tissue might be related to increased expression of angiotensin-converting enzymes-2 (ACE2) receptors in the heart. SARS-CoV-2, the virus that causes COVID-19, exploits ACE2 to gain entry into cells. Cytokine storm can occur in COVID-19 when SARS-CoV-2 infection provokes an excessive immune response that, in turn, induces multiple organ dysfunction. COVID-19 infection severely burdens the cardiovascular system, aggravating preexisting cardiovascular morbidities and triggering grave events, such as exacerbation of heart failure or acute coronary syndromes.

The authors also suggest that targeting inflammation – the underlying cause of the aforementioned drivers of cardiac injury – is critical to preserving cardiac health in COVID-19. They identify various drugs currently in use that target the central pathways associated with inflammation; balance the body’s immune responses; and reduce inflammation.

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