COVID-19 and Cardiovascular Implications in Older Adults: A Comprehensive Review

A recent comprehensive review called “COVID-19: A Comprehensive Review on Cardiovascular Alterations, Immunity, and Therapeutics in Older Adults” focuses on the significant impact of COVID-19 on older adults, particularly concerning cardiovascular and immune system dysfunctions.

Key points from the study include:

  1. Systemic Impact of COVID-19: While COVID-19 primarily affects the respiratory system, it also leads to systemic diseases with severe clinical manifestations. Cardiovascular and immune system dysfunctions are among the major concerns, with aging and comorbidities being significant risk factors for severe outcomes and poor prognosis​​.
  2. Cardiovascular Alterations in COVID-19 Patients: Patients often show myocardial injury, which can occur with or without clinical manifestations. Conditions such as hypoxia, Takotsubo syndrome, endothelial damage, vascular dysfunction, myocarditis, and a systemic inflammatory response known as a cytokine storm are common. These complications can lead to cardiomyocyte death, with myocardial damage incidence rising to 30% in patients over 60 years old, which is double the rate seen in younger patients​​.
  3. Long-Term Cardiovascular Outcomes: A follow-up study in the U.S. highlighted the long-term cardiovascular risks associated with COVID-19. These risks persist beyond the first month after infection, and they are pronounced for conditions like heart failure and atrial fibrillation, regardless of hospitalization or other cardiovascular risk factors​​.
  4. Cardiogenic Shock as a Cause of Mortality: Cardiogenic shock, resulting from severe impairment of myocardial outcomes, is a common cause of mortality in COVID-19 patients. This condition is exacerbated by pre-existing cardiovascular dysfunctions and is more fatal in older patients​​.
  5. Coagulation Abnormalities: COVID-19 patients exhibit various coagulation abnormalities, with increased levels of prothrombotic factors like factor VIII, fibrinogen, and prothrombotic microparticles. Elevated neutrophil counts and D-dimer levels indicate a higher risk of thromboembolic events, especially in critically ill patients​​.

This review emphasizes the need for comprehensive and improved medical care for elderly COVID-19 patients to prevent cardiovascular and immunological alterations. It also highlights the importance of therapies, including antivirals, cytokine antagonists, cytokine signaling pathway inhibitors, and vaccines, in managing these disorders.

Read More: https://www.mdpi.com/2077-0383/12/2/488

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