The prevalence and course of COVID-19 and the Cardiovascular Diseases

The SARS-CoV2 virus has infected over 545 million people and has claimed over 6 million lives globally by the end of June 2022. The global case fatality rate ranged from 5.5% in Mexico, 2.1-2.5% in South Africa, Brazil, Guatemala, Russia, 1.1-1.5% in the United States, Canada, India and Chile, 0.5-0.9% in Western European countries, 0.3% in Japan, 0.2% in Taiwan to 0.1% in Australia. Among hospitalized COVID-19 patients, the prevalence of pre-existing cardiovascular diseases was approximately 10%. The prevalence of cardiovascular diseases among COVID-19 non-survivors and COVID-19 patients requiring intensive care unit admission were approximately 20-30%. In a multicenter study of 8910 COVID-19 patients from 169 hospitals in Asia, Europe and North America, presence of pre-existing coronary artery disease, chronic heart failure and cardiac arrhythmia was associated with increased mortality of 10.2%, 15.3% and 11.5% respectively, compared with 5-6% mortality in those without the above co-morbidities. The systemic inflammation caused by SARS-CoV-2 could lead to a wide spectrum of cardiovascular complications including acute cardiac injury, acute coronary syndrome, coronary artery dissection, acute myocarditis, cardiomyopathy, chronic heart failure, cardiac arrhythmia, pulmonary embolism, cardiogenic shock, circulatory failure or even cardiac arrest.