The Effect of COVID-19 on Cardiovascular Diseases and the Need for Beta-Blocker Dose Modification
DOI:
https://doi.org/10.12775/JEHS.2024.74.51789Keywords
beta-blockers, SARS-Cov- 2, cardiovascular diseases, Long-COVIDAbstract
Introduction and purpose: The Coronavirus Disease 2019 (COVID-19) and its effects on patients remain the main focus of many researchers across the world. One of the challenges faced by medical professionals is the impact of the infection on the course of chronic diseases. Manifestations of the infection are observed mainly in the respiratory system, but other organs, particularly the cardiovascular system, are also frequently affected. Recent data indicates that arterial hypertension and cardiovascular diseases (CVD) are the most prevalent comorbidities in patients suffering from SARS-CoV-2 infection.
Material and methods: This study aimed to investigate the impact of SARS-CoV-2 infection on the cardiovascular system. Apart from the literature review we conducted a retrospective study to check the necessity for modification of chronic treatment in patients with CVD after recovery from COVID-19, particularly regarding the use of beta blockers.
Results: Using the Mann-Whitney U test a positive correlation (p = 0.04) was found between the presence of coronary artery disease before COVID-19 and a need for an increase in the beta-blockers dose.
Conclusions: Patients with preexisting CVD should be closely monitored during and after recovery from SARS-CoV-2 infection due to the higher risk of complications and the potential need for modifications in the treatment of chronic diseases. Patients with coronary artery diseases may need an increase in beta-blocker doses after recovery. This is an important issue for future research, especially in the context of long COVID-19.
References
Júnior RA, Durães A, Roever L, Macedo C, Aras MG, Nascimento L, et al. The Impact of COVID-19 on the Cardiovascular System. Rev Assoc Med Bras (1992) [Internet]. 2021 [cited 2023 Nov 15];67Suppl 1(Suppl 1):163–7. Available from: https://pubmed.ncbi.nlm.nih.gov/34259776/
Shi S, Shi S, Shi S, Qin M, Cai Y, Liu T, et al. Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. Eur Heart J [Internet]. 2020 Jun 7 [cited 2023 Nov 15];41(22):2070–9. Available from: /pmc/articles/PMC7239100/
Drake TM, Riad AM, Fairfield CJ, Egan C, Knight SR, Pius R, et al. Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. Lancet [Internet]. 2021 Jul 7 [cited 2023 Nov 17];398(10296):223. Available from: /pmc/articles/PMC8285118/
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. www.thelancet.com [Internet]. 2020 [cited 2023 Nov 17];395:497. Available from: https://isaric.tghn.org/protocols/
Raman B, Bluemke DA, Lüscher TF, Neubauer S. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J [Internet]. 2022 Mar 14 [cited 2023 Nov 17];43(11):1157–72. Available from: https://dx.doi.org/10.1093/eurheartj/ehac031
Liu F, Liu F, Wang L. COVID-19 and cardiovascular diseases. J Mol Cell Biol [Internet]. 2021 Jul 6 [cited 2023 Nov 17];13(3):161–7. Available from: https://dx.doi.org/10.1093/jmcb/mjaa064
A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 [Internet]. [cited 2023 Nov 17]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
Ismail H, Marshall VD, Patel M, Tariq M, Mohammad RA. The impact of the COVID-19 pandemic on medical conditions and medication adherence in people with chronic diseases. Journal of the American Pharmacists Association [Internet]. 2022 May 1 [cited 2023 Nov 17];62(3):834. Available from: /pmc/articles/PMC8591859/
Olmastroni E, Galimberti F, Catapano AL, Tragni E, Casula M. Beta-blockers in post-acute myocardial infarction patients: Drug prescription patterns from 2018 to Italy’s first wave of the COVID-19 pandemic. Front Pharmacol [Internet]. 2022 Dec 7 [cited 2023 Nov 17];13. Available from: https://pubmed.ncbi.nlm.nih.gov/36569305/
Clemente-Moragón A, Martínez-Milla J, Oliver E, Santos A, Flandes J, Fernández I, et al. Metoprolol in Critically Ill Patients With COVID-19. 2021 [cited 2023 Nov 18]; Available from: https://doi.org/10.1016/j.jacc.2021.07.003
Onohuean H, Al-kuraishy HM, Al-Gareeb AI, Qusti S, Alshammari EM, Batiha GES. Covid-19 and development of heart failure: mystery and truth. Naunyn Schmiedebergs Arch Pharmacol [Internet]. 2021 Oct 1 [cited 2023 Nov 18];394(10):2013–21. Available from: https://pubmed.ncbi.nlm.nih.gov/34480616/
Vasanthakumar N. Beta-Adrenergic Blockers as a Potential Treatment for COVID-19 Patients. BioEssays. 2020 Nov 1;42(11).
Alsagaff MY, Prasetya E, Mulia B. Opinion Paper Hypertension and COVID-19: Potential use of beta-blockers and a call for randomized evidence. 2021 [cited 2023 Nov 18]; Available from: https://doi.org/10.1016/j.ihj.2021.10.011
Li J, Sun W, Guo Y, Ren Y, Li Y, Yang Z. Prognosis of β-adrenergic blockade therapy on septic shock and sepsis: A systematic review and meta-analysis of randomized controlled studies. Cytokine. 2020 Feb 1;126:154916.
Heriansyah T, Chomsy IN, Febrianda L, Hadi TF, Wihastuti TA. Scientia Pharmaceutica The Potential Benefit of Beta-Blockers for the Management of COVID-19 Protocol Therapy-Induced QT Prolongation: A Literature Review. [cited 2023 Nov 18]; Available from: www.mdpi.com/journal/scipharm
Visseren F, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J [Internet]. 2021 Sep 7 [cited 2023 Nov 18];42(34):3227–337. Available from: https://dx.doi.org/10.1093/eurheartj/ehab484
Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res [Internet]. 2020 Aug 8 [cited 2023 Nov 18];116(10):1666. Available from: /pmc/articles/PMC7197627/
Prameswari HS, Putra ICS, Raffaello WM, Nathaniel M, Suhendro AS, Khalid AF, et al. Managing Covid-19 in patients with heart failure: current status and future prospects. Expert Rev Cardiovasc Ther [Internet]. 2022 [cited 2023 Nov 18];20(10):807–28. Available from: https://dx.doi.org/10.1080/14779072.2022.2132230
Huang L, Zhao P, Tang D, Zhu T, Han R, Zhan C, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC Cardiovasc Imaging [Internet]. 2020 Nov 1 [cited 2023 Dec 13];13(11):2330–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32763118/
Mahajan S, Kunal S, Shah B, Garg S, Palleda GM, Bansal A, et al. Left ventricular global longitudinal strain in COVID‐19 recovered patients. Echocardiography [Internet]. 2021 Oct 1 [cited 2023 Dec 13];38(10):1722. Available from: /pmc/articles/PMC8653213
Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol [Internet]. 2020 Nov 1 [cited 2023 Dec 13];5(11):1265–73. Available from: https://pubmed.ncbi.nlm.nih.gov/32730619/
Lee KK, Rahimi O, Lee CK, Shafi A, Hawwass D. A Meta-Analysis: Coronary Artery Calcium Score and COVID-19 Prognosis. Medical Sciences [Internet]. 2022 Jan 21 [cited 2023 Nov 18];10(1). Available from: /pmc/articles/PMC8883990/
Azevedo RB, Botelho BG, Hollanda JVG de, Ferreira LVL, Junqueira de Andrade LZ, Oei SSML, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens [Internet]. 2021 Jan 1 [cited 2023 Nov 18];35(1):4. Available from: /pmc/articles/PMC7384729/
Basu-Ray I, Almaddah N k., Adeboye A, Soos MP. Cardiac Manifestations of Coronavirus (COVID-19). StatPearls [Internet]. 2023 Jan 9 [cited 2023 Nov 18]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK556152/
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA [Internet]. 2020 Mar 3 [cited 2023 Nov 18];323(11):1061. Available from: /pmc/articles/PMC7042881/
Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J [Internet]. 2020 Jan 14 [cited 2023 Dec 11];41(3):407–77. Available from: https://pubmed.ncbi.nlm.nih.gov/31504439/
Castanares-Zapatero D, Chalon P, Kohn L, Dauvrin M, Detollenaere J, Maertens De Noordhout C, et al. Pathophysiology and mechanism of long COVID: a comprehensive review. 2022 [cited 2023 Dec 11]; Available from: https://www.tandfonline.com/action/journalInformation?journalCode=iann20
Mauer N, Chiecca G, Carioli G, Gianfredi V, Iacoviello L, Bertagnolio S, et al. The First 110,593 COVID-19 Patients Hospitalised in Lombardy: A Regionwide Analysis of Case Characteristics, Risk Factors and Clinical Outcomes. Int J Public Health [Internet]. 2022 May 11 [cited 2023 Dec 13];67. Available from: https://pubmed.ncbi.nlm.nih.gov/35645700/
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet [Internet]. 2020 Mar 28 [cited 2023 Dec 13];395(10229):1054–62. Available from: http://www.thelancet.com/article/S0140673620305663/fulltext
Zuin M, Rigatelli G, Zuliani G, Rigatelli A, Mazza A, Roncon L. Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis. Journal of Infection [Internet]. 2020 Jul 1 [cited 2023 Dec 13];81(1):e84–6. Available from: http://www.journalofinfection.com/article/S0163445320301894/fulltext
Chouchana L, Beeker N, Garcelon N, Rance B, Paris N, Salamanca E, et al. Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19. Cardiovasc Drugs Ther [Internet]. 2022 Jun 1 [cited 2023 Dec 13];36(3):483–8. Available from: https://link.springer.com/article/10.1007/s10557-021-07155-5
Yan F, Huang F, Xu J, Yang P, Qin Y, Lv J, et al. Antihypertensive drugs are associated with reduced fatal outcomes and improved clinical characteristics in elderly COVID-19 patients. Cell Discov [Internet]. 2020 Dec 1 [cited 2023 Dec 13];6(1):77. Available from: /pmc/articles/PMC7595708/
Pinto-Sietsma SJ, Flossdorf M, Buchholz VR, Offerhaus J, Bleijendaal H, Beudel M, et al. Antihypertensive drugs in COVID-19 infection. Eur Heart J Cardiovasc Pharmacother [Internet]. 2020 Nov 1 [cited 2023 Dec 13];6(6):415. Available from: /pmc/articles/PMC7314060/
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