Coronaviruses and the Cardiovascular System: Acute and Long-term Implications

Tian-Yuan Xiong; Simon Redwood; Bernard Prendergast; Mao Chen


Eur Heart J. 2020;41(19):1798-1800. 

In This Article

Epidemiological Overview of Recent Outbreaks of Respiratory Virus Infection

Respiratory virus infection is a major source of global pandemics as a consequence of swift human-to-human respiratory tract transmission. Within the past two decades, coronaviruses and influenza viruses have hit the world several times, causing significant mortality, economic loss, and global panic. The SARS outbreak in 2002 triggered 916 deaths among more than 8000 patients in 29 countries, followed by the emergence of MERS in 2012, which resulted in at least 800 deaths among 2254 patients in 27 countries.[2] Besides coronaviruses, avian and swine influenza remain a concern for global public health—in the 2009 H1N1 pandemic alone, there were 18 500 laboratory-confirmed deaths and more than 200 000 deaths from respiratory disease worldwide (based upon epidemiological modelling).[3]

In late 2019, a cohort of patients presenting with pneumonia of varying acuity and unknown aetiology in Wuhan, China heralded the outset of COVID-19. As of 16 March 2020, a total of 167 511 confirmed cases (including 6606 deaths in 152 geographical territories) have been reported to the World Health Organization (Take home figure), and this number is still increasing. Although COVID-19 appears to have greater infectivity and lower mortality than SARS and MERS, many uncertainties (including route of infection, viral evolution, epidemic dynamics, appropriate anti-viral treatment, and strategies for disease control) remain.

Take home figure

Current global distribution of COVID-19 and cardiovascular consequences of respiratory virus infection. (A) The global distribution of COVID-19 on 16March 2020 (figure source:COVID-19 situation reports fromWorld HealthOrganization). (B) Direct and indirect cardiovascular consequences of respiratory virus infection.