FUTURE PROGNOSIS FOR CARDIOVASCULAR COMPLICATIONS ASSOCIATED WITH
SARS-COV-2: A PHARMACOLOGICAL AND MOLECULAR PERSPECTIVE
Background: The severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19), which
is associated with cardiovascular problems and serious lung damage.
COVID-19 patients with comorbid conditions are at a significantly
elevated risk of increased morbidity and mortality.
Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine
2 (TMPRSS2) are the two key host contributing factors for the severity
and pathogenesis of COVID-19. The principal SARS-CoV-2 entrance
receptor, ACE2, is expressed equally in most organs and produces
cardio-protective vasodilators by physically degrading angiotensin II,
the main controller of the Renin-Angiotensin Aldosterone System.
However, treatment for cardiovascular disease (CVD) commonly involves
RAAS inhibitors, which may increase ACE2 expression. Objective:
To summarize the pharmacological molecular discoveries into the
processes of viral infection and its consequences for cardiovascular
disease and to offer suggestions for the practical management and
treatment of COVID-19-related cardiovascular injury. Methods:
This review focuses on the important considerations related to the
cardiovascular manifestations of COVID-19 and discusses the various
mechanisms of COVID-19 that contribute to its molecular and
pharmacological presentation of cardiovascular injury. Results:
The host-pathogen relationship began with ACE2’s attachment to the
S-protein and proceeded with TMPRSS2’s proteolytic cleavage of the viral
spike (S)-protein and ACE2. Currently discovered protein-protein
interactions explain the uniqueness of SARS-CoV-2 infection.
Conclusion: COVID-19 is associated with cardiovascular problems
and serious lung damage. ACE2 and TMPRSS2 are key host contributing
factors for the severity and pathogenesis of COVID-19. The molecular
discoveries into the processes of viral infection and its consequences
for cardiovascular disease provide important considerations for the
management and treatment of COVID-19-related cardiovascular injury.