Introduction
The COVID-19 has led to more than 171,000 deaths globally despite existing for less than five months. (Worldometer, 2020). In the U.S alone, the disease has killed more than 42, 000 with another 14,000 patients currently in critical condition. Although most of the people who contract the virus experience mild symptoms and ultimately recover, some develop severe respiratory and cardiovascular diseases leading to death. As such, the understanding of how the infection distresses the two vital systems in the human body is imperative in battling the deadly virus. This paper focuses on ways in which the disease distresses patients’ respiratory and cardiovascular systems, which has led to death in some severe cases.
Effects on the respiratory system
The respiratory system is one of the most vulnerable systems to the new SARS-CoV-2 that causes COVID-19 (World Health Organization, 2020). The system consists of the throat, nose, and lungs. The lungs are the main respiratory organs. Once the droplets from the breath cough or sneeze of an infected person come into contact with the nose, mouth, or eyes, the viruses in them are transferred to the mucous membrane in the throat (Rizzo et al., 2020). The virus then moves down the respiratory tract to the lungs. Once in the lungs, the virus replicates while damaging cells in the respiratory organ.
One of the reasons why the coronavirus causes more distress to the lungs and the heart compared to other viruses, including those that cause the common cold, is the presence of numerous ACE2 receptors in the lower airways and the heart. Based on the available evidence, scientists believe that the SARS-CoV-2 uses ACE2 as functional receptors. The virus uses its spike protein to bind onto host cells via the ACE2. Once a significant number of alveolar epithelial cells are infected, the patient starts showing respiratory abnormality symptoms.
A major sign of the infection is the inflammation of the lungs. This condition makes the patient unable to breathe normally. The difficulty in breathing then leads to malfunctioning of alveoli, which are minute air sacs found in the lungs. Since the air sacs are the site where carbon dioxide from the body is exchanged with oxygen from inhaled air, uptake of enough oxygen becomes difficult. The body responds by altering the breathing patterns to compensate for the oxygen shortage. If the infection continues, the patient may develop acute respiratory distress syndrome (ARDS) within a few days.
The ARDS causes a buildup of fluids in the alveoli of the infected person, preventing the proper exchange of carbon dioxide from the body and oxygen from the inhaled air. As a result, vital organs in the body, such as the brain, heart, and kidney, are denied adequate oxygen, leading to malfunctioning (WebMd, 2020). During the ARDS stage, patients may show symptoms such as cough, fever, breathe shortness, fast breath rates, low blood pressure, chest pains, exhaustion and confusion, and dizziness.
How COVID-19 distresses the cardiovascular system
Indirect effects of SARS-CoV-2 on the cardiovascular system
Throughout the pandemic, the focus of COVID-19 management has targeted the respiratory system through solutions such as the use of ventilators and other treatments. However, some anecdotal reports indicated that SARS-Cov-2 infection increased the risk of heart attacks or myocardial infarction as well as a coronary syndrome (Mandal, 2020). Research later confirmed that people suffering from heart disease or cardiovascular disease (CVD) are more vulnerable to the effects of the COVID-19, which could cause both respiratory and cardiovascular systems. Although the virus may attack both lungs and heart of previously healthy individuals, people with CVD are more prone to severe symptoms. The role of ACE2 as a functional receptor may help explain this observation. During the progression of CVD, the body of the infected person releases more ACE2 through the use of system inhibitors of the renin-angiotensin-aldosterone (WHO, 2020). This increase results in widespread attacks of the organ, leading to severe symptoms.
Most medics believe that COVID-19 affects patients in one or a combination of some or all five common ways. First, COVID-19 patients with a compromised respiratory system may ultimately develop pneumonia. Since the respiratory disease prevents the passage of oxygen to the bloodstream, some organs, including the heart, could be adversely affected, leading to organ failure (Hawryluk, 2020). When the distress of the cardiovascular system due to lack of oxygen is excessive, the heart stops, and the patient dies.
The distress to the cardiovascular system may also be due to the stress caused by the patients’ awareness of the danger of the infection (Hawryluk, 2020). Medical experts have long believed that such a serious medical event as a COVID-19 infection may cause too much psychological stress.
Excessive distress on a patients’ cardiovascular system may also be due to the large-scale inflammation caused by pneumonia among patients. The inflammation may then destabilize blood vessels, including the arteries. This instability, in turn, leads to heart attacks (Hawryluk, 2020). Evidence also shows that the inflammation due to pneumonia may also trigger myocarditis, a condition characterized by loss of strength of the heart muscles. This condition overwhelms the cardiovascular system in its role of pumping blood to the rest of the body. Ultimately, the patient with such a condition may die.
Scientists differ on the exact mode of action of the virus on the cardiovascular system, but they now agree that the coronavirus disease-2019 accelerates existing heart diseases. This finding explains why people’s heart conditions at an asymptomatic or early-stage may start showing symptoms soon after infection with the COVID-19. The virus causes fever and inflation of the blood vessels, which worsens the health of individuals with an existing blockage of blood vessels. The constriction of blood vessels makes them prone to clots while reducing the body’s mechanism to fight the illness.
Direct effects of COVID-19 on the cardiovascular system
The recent discovery linking adverse effects of COVID-19 on the cardiovascular system and the presence of a large number of ACE2 receptors in the heart tissues has created another speculation. Scientists now believe that direct viral damage to heart muscles is highly possible (Hawryluk, 2020). As such, more studies are underway to understand the phenomenon by pursuing the causes of heart problems in COVID-19 patients.
The findings of an initial study revealed that 20% of the patients developed cardiac damage, which led to heart failure and death in some cases. At the beginning of April, researchers established that COVID-19 patients were also developing heart complications. This realization created the dilemma of whether the cardiac damage was as a result of direct or indirect effects of the virus (Hawryluk, 2020). Additionally, some of the patients developed heart problems and died without showing any respiratory distress signs.
In brief, the whole mechanism in which the COVID-19 distresses its patients’ cardiovascular and respiratory systems is not yet fully understood. As the disease is still new to medics and medical researchers, numerous medical studies are currently underway to create more knowledge about the disease. Physicians hope that new knowledge will help combat the dangerous infection that has disrupted global economies. However, existing evidence indicates that the disease first interrupts and overwhelms the respiratory system, which then interferes with the normal functioning of the cardiovascular system, given the two systems are highly interdependent. Even then, exceptional cases have pointed to the possibility of direct distress of the cardiovascular system by the SARS-CoV-2 virus. This possibility has effectively broadened the search for the COVID-19 management technique to include the cardiovascular system.
References
Hawryluk, M. (2020). Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients. Kaiser Health News. Retrieved 21 April 2020, from https://khn.org/news/mysterious-heart-damage-not-just-lung-troubles-befalling-covid-19-patients/.
Mandal, A. (2020). COVID-19 and its effects on the cardiovascular system. News-Medical.net. Retrieved 21 April 2020, from https://www.news-medical.net/news/20200329/COVID-19-and-its-effects-on-the-cardiovascular-system.aspx.
Rizzo, P., Vieceli Dalla Sega, F., Fortini, F., Marracino, L., Rapezzi, C., & Ferrari, R. (2020). COVID-19 in the heart and the lungs: could we “Notch” the inflammatory storm?. Basic research in cardiology, 115(3), 31. https://doi.org/10.1007/s00395-020-0791-5
WebMd, (2020). Acute Respiratory Distress Syndrome (ARDS). WebMD. Retrieved 21 April 2020, from https://www.webmd.com/lung/ards-acute-respiratory-distress-syndrome#1.
World Health Organization, & World Health Organization. (2020). Report of the who-china joint mission on coronavirus disease 2019 (covid-19). Recovered from https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
Worldometer. (2020). Coronavirus Update (Live): 2,503,392 Cases and 171,796 Deaths from COVID-19 Virus Pandemic – Worldometer. Worldometers.info. Retrieved 21 April 2020, from https://www.worldometers.info/coronavirus/?utm_campaign=homeAdvegas1.