Novel coronaviruses can cause serious diseases such as pneumonia and progressive respiratory infections but it should not be a reason to neglect the cardiovascular problems. There is much evidence which suggests that most of the morbidity and mortality cases of novel coronavirus are related to cardiovascular disease [10, 11].
Based on the previous studies, viral infections such as influenza and their analogs can destabilize and worsen cardiac conditions. Cardiac complications are the secondary diseases of SARS-CoV and MERS-CoV (as an earlier coronavirus family) [10]. Moreover, Yu CM et al. reported cardiomegaly in 11% of patients with SARS[12]. In another study, cardiomegaly reported being observed in patients with COVID 19 [13]. Thus, we decided to evaluate the prevalence of cardiac diseases, specially cardiomegaly in COVID-19 patients. In the present paper, the biography, laboratory, clinical, and chest CT data of 115 patients hospitalized in Baqyatallah hospital were investigated. The results showed that the percentage of cardiovascular diseases and hypertension comorbidities in three groups (with Cardiomegaly, Calcification detection, without Cardiomegaly or Calcification) were 9.09%, 15.79% and 5%, respectively. Based on the recent reports, cardiovascular diseases and hypertension comorbidities in patients with COVID-19 is much higher [10]. The report showed that patients with COVID-19 are at high risk of having cardiovascular complications or mortality [14]. The data of the present study demonstrated that 48.49% of patients with cardiomegaly and 30.02% cardiomegaly with calcification did not report any comorbidities. It’s worth noting that vascular calcification is a long-term process in which viral type has also been reported. But, it seems that patients who have not reported calcification were unaware of their disease.
Researchers found that C-reactive protein (CRP) is an inflammatory the predictor of heart disease [15, 16]. Other routine laboratory factors which provide useful prognostic information for heart failure included blood urea, nitrogen and creatinine [17–19]. The results of the present study demonstrated that CRP, blood urea nitrogen and creatinine levels significantly increased in patients with Cardiomegaly and Calcification compared to healthy groups (mild to severe trend).
The mechanism of novel corona-infected cardiovascular disease remained unknown. But the recent reports show the role of (ACE2) receptors in SARS-CoV-2 and COVID − 19 pathogenicity and their entry to the principally Type II alveolar cells [10, 11, 20].
The investigators have indicated the high expression of ACE2 in the heart and lung. Moreover,ACE2 is expressed in other organs such as vascular endothelium and kidney explaining the multi-organ dysfunction and can be found in SARS-CoV-2 infection [10, 11, 20].
In conclusion, preexisting cardiovascular disease may enhance vulnerability to COVID-19 and it can greatly affect the development and prognosis of pneumonia (Table 1: Mortality rate). Further, secondary damage of the virus on the cardiovascular system (short-term vs long-term cardiovascular effects) should not be forgotten. Therefore, therapists should pay attention to viral infection relating to cardiovascular diseases. The short time and longtime follow-ups of these patients are suggested.