Cardiovascular diseases and obesity: The concise systematic review in the context of SARS-CoV-2

Author(s): Marcelo Melo Martins, Bernardo Pessoa de Assis, Danilo Lopes Assis, Max Paulo Pimentel de Jesus, Ericka Camara Ferreira da Rocha, Tiago Teixeira Correa de Barros, Violeta Gisella Bendezu Garcia, Jose Mauricio de Vasconcellos Neto Segundo, Neli Dalva Matheus, Eliana Migliorini Mustafa, Idiberto Jose Zotarelli Filho

Introduction: COVID-19 disease is associated with vascular inflammatory processes, myocarditis, and cardiac arrhythmias, worsening CVD, diabetes, and hypertension. In this scenario, SARS-CoV-2 is worsening the comorbidities of obesity.

Objective: To conduct a summary systematic review on the main relationships of COVID-19 with cardiovascular diseases and obesity, highlighting the main physiometabolic and pathological mechanisms.

Strategy: The search strategy was carried out in the PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus databases. After a complete analysis of these selected studies, in the scenario of cardiovascular diseases (CVD), obesity initially favors the development of inflammation in adipose tissue, by increasing the production of pro-inflammatory adipokines. Metainflammation leads to myocardial dysfunction by direct injury to inflammatory mediators, as well as by dysfunction to other organs. Thus, the endothelial dysfunction caused by SARS-CoV-2 justifies blood vessel-related comorbidities such as cardiovascular disease, hypertension, diabetes, and obesity are more likely to develop severe COVID-19.

Conclusion: COVID-19 disease is associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Cardiovascular disease and pharmacological inhibition of COVID-19 increase ECA2 levels, which can increase the virulence of the coronavirus in the lung and heart. Also, obesity is an important predictor of worsening SARS-CoV-2 pathology.