Sex differences underlying preexisting cardiovascular disease and cardiovascular injury in COVID-19

J Mol Cell Cardiol. 2020 Nov:148:25-33. doi: 10.1016/j.yjmcc.2020.08.007. Epub 2020 Aug 22.

Abstract

The novel 2019 coronavirus disease (COVID-19), resulting from severe acute respiratory syndrome coronarvirus-2 (SARS-CoV-2) infection, typically leads to respiratory failure in severe cases; however, cardiovascular injury is reported to contribute to a substantial proportion of COVID-19 deaths. Preexisting cardiovascular disease (CVD) is among the most common risk factors for hospitalization and death in COVID-19 patients, and the pathogenic mechanisms of COVID-19 disease progression itself may promote the development of cardiovascular injury, increasing risk of in-hospital death. Sex differences in COVID-19 are becoming more apparent as mounting data indicate that males seem to be disproportionately at risk of severe COVID-19 outcome due to preexisting CVD and COVID-19-related cardiovascular injury. In this review, we will provide a basic science perspective on current clinical observations in this rapidly evolving field and discuss the interplay sex differences, preexisting CVD and COVID-19-related cardiac injury.

Keywords: ACE2; Arrhythmia; COVID-19; Cardiovascular; Sex differences; Thrombosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiotensin-Converting Enzyme 2 / genetics
  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / epidemiology
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / genetics
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology*
  • Disease Progression
  • Disease Susceptibility
  • Endothelium, Vascular / pathology
  • Female
  • Humans
  • Inflammation
  • Male
  • Microcirculation
  • Obesity / complications
  • Risk Factors
  • Sex Factors*
  • Smoking
  • Thrombosis / complications
  • Thrombosis / epidemiology

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2