COVID-19 and Cardiovascular Comorbidities

Dirk Müller-Wieland; Nikolaus Marx; Michael Dreher; Katharina Fritzen; Oliver Schnell

doi:10.1055/a-1269-1405

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2022; 130(03): 178-189
DOI: 10.1055/a-1269-1405

Review

COVID-19 and Cardiovascular Comorbidities

Dirk Müller-Wieland

¹Clinic for Cardiology, Angiology and Internal Care Medicine (Medical Clinic I) Universitatsklinikum Aachen, Aachen

,

Nikolaus Marx

¹Clinic for Cardiology, Angiology and Internal Care Medicine (Medical Clinic I) Universitatsklinikum Aachen, Aachen

,

Michael Dreher

²Clinic for Pneumology and Internal Intensive Care Medicine (Medical Clinic V, Uniklinik RWTH Aachen, Aachen

,

Katharina Fritzen

³Sciarc GmbH, Baierbrunn

,

Oliver Schnell

³Sciarc GmbH, Baierbrunn

⁴Forschergruppe Diabetes e.V., Munich Neuherberg

› Author Affiliations

Abstract

The emergence of a new coronavirus - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - has resulted in a global pandemic. The associated coronavirus disease 2019 (COVID-19) has resulted in a high number of death worldwide. Observational studies and case reports have provided insights that older age and the presence of chronic diseases is frequently associated with a higher COVID-19 severity. These individuals also seem to have a higher risk of mortality due to COVID-19. In this review we provide insights into the impact chronic diseases associated with the cardiovascular system, such as obesity, diabetes mellitus, hypertension and cardiovascular disease might have on SARS-CoV-2 infection and COVID-19. Additionally we review recommendations and guidance’s of international scientific associations and discuss which key learnings might be of importance for the future.

Key words

SARS-CoV-2 - COVID-19 - obesity - diabetes mellitus - hypertension, cardiovascular incidences - cardiovascular disease

Full Text

References

References
1 World Health Organization. WHO coronavirus disease (COVID-19) dashboard. In. Geneva; 2020
2 Rizzo M, Foresti L, Montano N. Comparison of Reported Deaths From COVID-19 and Increase in Total Mortality in Italy. JAMA Internal Medicine 2020;
3 Mannucci E, Nreu B, Monami M. Factors associated with increased all-cause mortality during the COVID-19 pandemic in Italy. Int J Infect Dis 2020;
4 Vestergaard LS, Nielsen J, Richter L. et al. Excess all-cause mortality during the COVID-19 pandemic in Europe – preliminary pooled estimates from the EuroMOMO network, March to April 2020. Eurosurveillance 2020; 25 2001214
5 Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama 2020;
6 Böhm M, Frey N, Giannitsis E. et al. Coronavirus Disease 2019 (COVID-19) and its implications for cardiovascular care: expert document from the German Cardiac Society and the World Heart Federation. Clin Res Cardiol 2020; 1-14
7 Varga Z, Flammer AJ, Steiger P. et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet 2020; 395: 1417-1418
8 Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 2017; 39: 529-539 10.1007/s00281-017-0629-x
9 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England) 2020; 395: 497-506
10 Wang D, Hu B, Hu C. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama 2020; 323: 1061-1069
11 Sama IE, Ravera A, Santema BT. et al. Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. European Heart Journal 2020; 41: 1810-1817
12 Williamson EJ, Walker AJ, Bhaskaran K. et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature 2020;
13 Dreher M, Kersten A, Bickenbach J. et al. The Characteristics of 50 Hospitalized COVID-19 Patients With and Without ARDS. Dtsch Arztebl International 2020; 117: 271-278
14 Karagiannidis C, Mostert C, Hentschker C. et al. Case characteristics, resource use, and outcomes of 10021 patients with COVID-19 admitted to 920 German hospitals: an observational study. The Lancet. Respiratory Medicine 2020;
15 Guo W, Li M, Dong Y. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes/metabolism research and reviews 2020; e3319
16 Caussy C, Pattou F, Wallet F. et al. Prevalence of obesity among adult inpatients with COVID-19 in France. The lancet Diabetes &. endocrinology 2020; 8: 562-564
17 Chen Q, Zheng Z, Zhang C. et al. Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Infection 2020; 1-9
18 Mahase E. Covid-19: most patients require mechanical ventilation in first 24 h of critical care. BMJ (Clinical research ed) 2020; 368: m1201 10.1136/bmj.m1201
19 Bhatraju PK, Ghassemieh BJ, Nichols M. et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. New England Journal of Medicine 2020; 382: 2012-2022
20 Simonnet A, Chetboun M, Poissy J. et al. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring) 2020; 28: 1195-1199
21 Cai SH, Liao W, Chen SW. et al. Association between obesity and clinical prognosis in patients infected with SARS-CoV-2. Infect Dis Poverty 2020; 9: 80
22 Lighter J, Phillips M, Hochman S. et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clin Infect Dis 2020; ciaa415
23 Gao F, Zheng KI, Wang XB. et al. Obesity Is a Risk Factor for Greater COVID-19 Severity. Diabetes Care 2020; 43: e72-e74
24 Pettit NN, MacKenzie EL, Ridgway J. et al. Obesity is Associated with Increased Risk for Mortality Among Hospitalized Patients with COVID-19. Obesity (Silver Spring) 2020;
25 Alberca RW, Oliveira LM, Branco A. et al. Obesity as a risk factor for COVID-19: an overview. Crit Rev Food Sci Nutr 2020; 1-15
26 Han JM, Patterson SJ, Speck M. et al. Insulin inhibits IL-10-mediated regulatory T cell function: implications for obesity. J Immunol 2014; 192: 623-629
27 Andersen CJ, Murphy KE, Fernandez ML. Impact of Obesity and Metabolic Syndrome on Immunity. Advances in nutrition (Bethesda, Md) 2016; 7: 66-75 10.3945/an.115.010207
28 Wang T, Du Z, Zhu F. et al. Comorbidities and multi-organ injuries in the treatment of COVID-19. Lancet (London, England) 2020; 395: e52
29 Yang X, Yu Y, Xu J. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. The Lancet Respiratory Medicine 2020; 8: 475-481
30 Guan W-j, Ni Z-y, Hu Y. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine 2020; 382: 1708-1720
31 Zhang J-j, Dong X, Cao Y-y et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020; DOI: 10.1111/all.14238
32 Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018; 12: 755-767 10.1080/17476348.2018.1506331
33 Chiappetta S, Sharma AM, Bottino V. et al. COVID-19 and the role of chronic inflammation in patients with obesity. Int J Obes (Lond) 2020; 1-3
34 Selim BJ, Ramar K, Surani S. Obesity in the intensive care unit: risks and complications. Hosp Pract (1995) 2016; 44: 146-156 10.1080/21548331.2016.1179558
35 Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic. Acta Diabetologica 2020; 57: 759-764 10.1007/s00592-020-01522-8
36 Frühbeck G, Baker JL, Busetto L. et al. European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic. Obesity Facts 2020; 13: 292-296
37 Li B, Yang J, Zhao F. et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol 2020; 109: 531-538
38 Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. Jama 2020; 323: 1775-1776 10.1001/jama.2020.4683
39 Wu C, Chen X, Cai Y. et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA internal medicine 2020; e200994
40 Yan Y, Yang Y, Wang F. et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ open diabetes research & care 2020; 8
41 Roncon L, Zuin M, Rigatelli G. et al. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J Clin Virol 2020; 127: 104354
42 Chung SM, Lee YY, Ha E. et al. The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study. Diabetes Metab J 2020; 44: 405-413
43 Fadini GP, Morieri ML, Longato E. et al. Prevalence and impact of diabetes among people infected with SARS-CoV-2. Journal of Endocrinological Investigation 2020; 43: 867-869
44 Mantovani A, Byrne CD, Zheng MH. et al. Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: A meta-analysis of observational studies. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD 2020;
45 Wu ZH, Tang Y, Cheng Q. Diabetes increases the mortality of patients with COVID-19: a meta-analysis. Acta Diabetologica 2020; 1-6 10.1007/s00592-020-01546-0
46 Wu J, Zhang J, Sun X. et al. Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection. Diabetes, Obesity & Metabolism 2020;
47 Zhu L, She ZG, Cheng X. et al. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metabolism 2020;
48 Wang L, Gao P, Zhang M. et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. Jama 2017; 317: 2515-2523
49 Bode B, Garrett V, Messler J. et al. Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States. J Diabetes Sci Technol 2020; 1932296820924469
50 Li H, Tian S, Chen T. et al. Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID-19. Diabetes, Obesity &. Metabolism 2020;
51 Cariou B, Hadjadj S, Wargny M. et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia 2020; 1-16
52 Coppelli A, Giannarelli R, Aragona M. et al. Hyperglycemia at Hospital Admission Is Associated With Severity of the Prognosis in Patients Hospitalized for COVID-19: The Pisa COVID-19 Study. Diabetes Care 2020; dc201380
53 Singh AK, Singh R. At-admission hyperglycemia is consistently associated with poor prognosis and early intervention can improve outcomes in patients with COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020;
54 Zhou J, Tan J. Diabetes patients with COVID-19 need better blood glucose management in Wuhan, China. Metabolism: Clinical and Experimental 2020; 107: 154216 10.1016/j.metabol.2020.154216
55 Allard R, Leclerc P, Tremblay C. et al. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care 2010; 33: 1491-1493
56 Booth CM, Matukas LM, Tomlinson GA. et al. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. Jama 2003; 289: 2801-2809
57 Yang JK, Feng Y, Yuan MY. et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med 2006; 23: 623-628
58 Nassar MS, Bakhrebah MA, Meo SA. et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: epidemiology, pathogenesis and clinical characteristics. Eur Rev Med Pharmacol Sci 2018; 22: 4956-4961
59 Ilyas R, Wallis R, Soilleux EJ. et al. High glucose disrupts oligosaccharide recognition function via competitive inhibition: a potential mechanism for immune dysregulation in diabetes mellitus. Immunobiology 2011; 216: 126-131
60 Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999; 26: 259-265 10.1111/j.1574-695X.1999.tb01397.x
61 Pearson-Stuttard J, Blundell S, Harris T. et al. Diabetes and infection: assessing the association with glycaemic control in population-based studies. The lancet Diabetes & endocrinology 2016; 4: 148-158
62 Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice 2020; 162: 108142-108142 10.1016/j.diabres.2020.108142
63 Yang JK, Lin SS, Ji XJ. et al. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetologica 2010; 47: 193-199
64 Brufsky A. Hyperglycemia, hydroxychloroquine, and the COVID-19 pandemic. J Med Virol 2020;
65 Bornstein SR, Dalan R, Hopkins D. et al. Endocrine and metabolic link to coronavirus infection. Nature Reviews. Endocrinology 2020; 16: 297-298
66 Pal R, Bhadada SK. COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes & Metabolic Syndrome 2020; 14: 513-517 10.1016/j.dsx.2020.04.049
67 Kumar V, Singh MP, Singh AP. et al. Efficacy and safety of hydroxychloroquine when added to stable insulin therapy in combination with metformin and glimepiride in patients with type 2 diabetes compare to sitagliptin 2018. 2018; 7: 6
68 Singh AK, Gupta R, Ghosh A. et al. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & Metabolic Syndrome 2020; 14: 303-310
69 Drucker DJ. Coronavirus Infections and Type 2 Diabetes-Shared Pathways with Therapeutic Implications. Endocrine reviews 2020; 41 : DOI: 10.1210/endrev/bnaa011
70 Pal R, Bhadada SK. Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?. Diabetes Research and Clinical Practice 2020; 163: 108146 https://doi.org/10.1016/j.diabres.2020.108146
71 Song Z, Xu Y, Bao L. et al. From SARS to MERS, Thrusting Coronaviruses into the Spotlight. Viruses 2019; 11
72 Chen Y, Yang D, Cheng B. et al. Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication. Diabetes Care 2020; 43: 1399-1407
73 Apicella M, Campopiano MC, Mantuano M. et al. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The lancet Diabetes & Endocrinology 2020;
74 Katulanda P, Dissanayake HA, Ranathunga I. et al. Prevention and management of COVID-19 among patients with diabetes: An appraisal of the literature. Diabetologia 2020; 63: 1440-1452
75 Bhimraj A, Morgan RL, Shumaker AH. et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis 2020;
76 Deutsche Diabetes Gesellschaft. Praktische Empfehlungen zum Diabetes-Management bei Patientinnen und Patienten mit einer COVID-19-Erkrankung. In; 2020
77 Bornstein SR, Rubino F, Khunti K. et al. Practical recommendations for the management of diabetes in patients with COVID-19. The Lancet Diabetes &. Endocrinology 2020; 8: 546-550
78 Ceriello A, Standl E, Catrinoiu D. et al. Issues of Cardiovascular Risk Management in People With Diabetes in the COVID-19 Era. Diabetes Care 2020; dc200941
79 Hartmann-Boyce J, Morris E, Goyder C. et al. Diabetes and COVID-19: Risks, Management, and Learnings From Other National Disasters. Diabetes Care 2020; dc201192
80 Tadic M, Cuspidi C, Grassi G. et al. COVID-19 and arterial hypertension: Hypothesis or evidence?. J Clin Hypertens (Greenwich) 2020;
81 Gao Y, Chen G, Tian H. et al. Prevalence of hypertension in china: a cross-sectional study. PloS one 2013; 8: e65938-e65938
82 Tocci G, Nati G, Cricelli C. et al. Prevalence and control of hypertension in the general practice in Italy: updated analysis of a large database. J Hum Hypertens 2017; 31: 258-262
83 Zhang J, Wu J, Sun X. et al. Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis. Epidemiol Infect 2020; 148: e106
84 Huang S, Wang J, Liu F. et al. COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study. Hypertension Research : Official Journal of the Japanese Society of Hypertension. 2020; 1-8
85 Yanai H. A Significance of High Prevalence of Diabetes and Hypertension in Severe COVID-19 Patients. J Clin Med Res 2020; 12: 389-392 10.14740/jocmr4218
86 Pranata R, Lim MA, Huang I. et al. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. Journal of the renin-angiotensin-aldosterone system : JRAAS 2020; 21 1470320320926899
87 Yang Q, Zhou Y, Wang X. et al. Effect of hypertension on outcomes of adult inpatients with COVID-19 in Wuhan, China: A propensity score-matching analysis. Respir Res 2020; 21: 172
88 Nandy K, Salunke A, Pathak SK. et al. Coronavirus disease (COVID-19): A systematic review and meta-analysis to evaluate the impact of various comorbidities on serious events. Diabetes & Metabolic Syndrome 2020; 14: 1017-1025
89 Parveen R, Sehar N, Bajpai R. et al. Association of diabetes and hypertension with disease severity in covid-19 patients: a systematic literature review and exploratory meta-analysis. Diabetes Research and Clinical Practice 2020; 108295
90 Singh AK, Gupta R, Misra A. Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes & Metabolic Syndrome 2020; 14: 283-287 10.1016/j.dsx.2020.03.016
91 Kulkarni S, Jenner BL, Wilkinson I. COVID-19 and hypertension. Journal of the renin-angiotensin-aldosterone system : JRAAS 2020; 21: 1470320320927851 10.1177/1470320320927851
92 Gao C, Cai Y, Zhang K. et al. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. European heart journal 2020; 41: 2058-2066
93 Harrison DG, Guzik TJ, Lob HE. et al. Inflammation, immunity, and hypertension. Hypertension (Dallas, Tex : 1979) 2011; 57: 132-140
94 De Miguel C, Rudemiller NP, Abais JM. et al. Inflammation and hypertension: new understandings and potential therapeutic targets. Current hypertension reports 2015; 17: 507-507
95 Perrotta M, Lori A, Carnevale L. et al. Deoxycorticosterone acetate-salt hypertension activates placental growth factor in the spleen to couple sympathetic drive and immune system activation. Cardiovascular Research 2018; 114: 456-467
96 Chou CH, Hung CS, Liao CW. et al. IL-6 trans-signalling contributes to aldosterone-induced cardiac fibrosis. Cardiovascular Research 2018; 114: 690-702
97 Hanff TC, Harhay MO, Brown TS. et al. Is There an Association Between COVID-19 Mortality and the Renin-Angiotensin System-a Call for Epidemiologic Investigations. Clin Infect Dis 2020;
98 Zhang P, Zhu L, Cai J. et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circulation Research 2020; 126: 1671-1681
99 European Society of Hypertension. Statement of the European Society of Hypertension (ESH) on hypertension, Renin-Angiotensin System(RAS) blockers and COVID-19. In; 2020
100 Kreutz R, Algharably EAE, Azizi M. et al. Hypertension, the renin-angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19. Cardiovascular Research 2020;
101 Heart Failure Society of America, American College of Cardiology, American Heart Association. HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. 2020:
102 European Society of Cardiology. Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers 2020:
103 Deutsche Gesellschaft für Kardiologie. COVID-19 und Behandlung mit Hemmstoffen des Renin-Angiotensin-Systems. In; 2020
104 World Hypertension League. COVID-19 hypertension guidance. In; 2020
105 Guo T, Fan Y, Chen M. et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA cardiology 2020; 5: 1-8
106 Aggarwal G, Cheruiyot I, Aggarwal S. et al. Association of Cardiovascular Disease With Coronavirus Disease 2019 (COVID-19) Severity: A Meta-Analysis. Curr Probl Cardiol 2020; 45: 100617-100617
107 Zhou F, Yu T, Du R. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 2020; 395: 1054-1062
108 Ruan Q, Yang K, Wang W. et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine 2020; 46: 846-848
109 Li X, Guan B, Su T. et al. Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis. Heart (British Cardiac Society) 2020; 106: 1142
110 Zhang J, Lu S, Wang X. et al. Do underlying cardiovascular diseases have any impact on hospitalised patients with COVID-19?. Heart (British Cardiac Society) 2020; 106: 1148-1153
111 Xu Z, Shi L, Wang Y. et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine 2020; 8: 420-422
112 Inciardi RM, Lupi L, Zaccone G. et al. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). JAMA cardiology 2020; 5: 819-824
113 Shi S, Qin M, Shen B. et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan. China. JAMA cardiology 2020;
114 Zheng Y-Y, Ma Y-T, Zhang J-Y. et al. COVID-19 and the cardiovascular system. Nature Reviews. Cardiology 2020; 17: 259-260
115 Madjid M, Safavi-Naeini P, Solomon SD. et al. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA cardiology 2020;
116 Lindner D, Fitzek A, Bräuninger H. et al. Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. JAMA cardiology 2020;
117 Cooper LT. Myocarditis. New England Journal of Medicine 2009; 360: 1526-1538 10.1056/NEJMra0800028
118 Lala A, Johnson KW, Januzzi JL. et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. J Am Coll Cardiol 2020; 76: 533-546
119 Xiong T-Y, Redwood S, Prendergast B. et al. Coronaviruses and the cardiovascular system: acute and long-term implications. European Heart Journal 2020; 41: 1798-1800
120 Rowland B, Kunadian V. Challenges in the management of older patients with acute coronary syndromes in the COVID-19 pandemic. Heart (British Cardiac Society) 2020; heartjnl-2020-317011 DOI:
121 Wu Q, Zhou L, Sun X. et al. Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection. Sci Rep 2017; 7: 9110
122 European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. In; 2020
123 Han Y, Zeng H, Jiang H. et al. CSC Expert Consensus on Principles of Clinical Management of Patients With Severe Emergent Cardiovascular Diseases During the COVID-19 Epidemic. Circulation 2020; 141: e810-e816
124 American Heart Association. Coronavirus (COVID-19). In; 2020
125 American College of Cardiology. COVID-19 Clinical Guidance for Global Cardiovascular Clinicians. In; 2020
126 Zaman S, MacIsaac AI, Jennings GL. et al. Cardiovascular disease and COVID-19: Australian and New Zealand consensus statement. The. Medical journal of Australia 2020;
127 Deutsche Gesellschaft für Kardiologie. Notfallversorgung von Patienten mit akuten Herzerkrankungen während der Corona-Pandemie. In; 2020
128 Fragala MHWK, Meigs J. et al. Consequences of the COVID-19 Pandemic: Reduced Hemoglobin A1c Diabetes Monitoring. Population Health Management 2020;
129 Karter AJ, Parker MM, Moffet HH. et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Medical Care 2004; 42: 110-115
130 Samuels TA, Bolen S, Yeh HC. et al. Missed opportunities in diabetes management: a longitudinal assessment of factors associated with sub-optimal quality. J Gen Intern Med 2008; 23: 1770-1777
131 Bonora BM, Boscari F, Avogaro A. et al. Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy. Diabetes Ther 2020; 1-11
132 Capaldo B, Annuzzi G, Creanza A. et al. Blood Glucose Control During Lockdown for COVID-19: CGM Metrics in Italian Adults With Type 1 Diabetes. Diabetes Care 2020;
133 Maddaloni E, Coraggio L, Pieralice S. et al. Effects of COVID-19 Lockdown on Glucose Control: Continuous Glucose Monitoring Data From People With Diabetes on Intensive Insulin Therapy. Diabetes Care 2020; 43: e86-e87
134 Baum A, Schwartz MD. Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic. Jama 2020; 324: 96-99 10.1001/jama.2020.9972
135 Lazzerini M, Barbi E, Apicella A. et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. The Lancet Child & Adolescent Health 2020; 4: e10-e11
136 Slagman A, Behringer W, Greiner F. et al. Medical Emergencies During the COVID-19 Pandemic. Dtsch Arztebl International 2020; 117: 545-552
137 Kamrath C, Mönkemöller K, Biester T. et al. Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany. Jama 2020;
138 Garcia S, Albaghdadi MS, Meraj PM. et al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. Journal of the American College of Cardiology 2020; 75: 2871-2872
139 Solomon MD, McNulty EJ, Rana JS. et al. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. New England Journal of Medicine 2020;
140 De Filippo O, D’Ascenzo F, Angelini F. et al. Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy. The. New England Journal of Medicine 2020; 383: 88-89
141 Marijon E, Karam N, Jost D. et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. The Lancet Public Health 2020;
142 Puntmann VO, Carerj ML, Wieters I. et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiology 2020;
143 Pierce M, Hope H, Ford T. et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. The Lancet Psychiatry 2020;
144 Bhaskar S, Rastogi A, Chattu VK. et al. Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. Frontiers in Cardiovascular Medicine 2020; 7: 112
145 Chudasama YV, Gillies CL, Zaccardi F. et al. Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals. Diabetes & metabolic syndrome 2020; 14: 965-967
146 Emerging Infections Task Force. Lean European Open Survey on SARS-CoV-2 infected patients” (LEOSS) database and research platform In; 2020