View source for Section 1: Introduction (from DOI: 10.1007/s11886-020-01293-2)

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<b>From publication:</b> "Cardiovascular Risks in Patients with COVID-19: Potential Mechanisms and Areas of Uncertainty" published as Curr Cardiol Rep; 2020 04 29 ; 22 (5) 34. DOI: https://doi.org/10.1007/s11886-020-01293-2 <br><br><h3><u>Section 1: Introduction</u></h3><p>Since its first documented human infection in Wuhan, China, in the winter of 2019, SARS-CoV-2, the causal agent of COronaVIrus Disease 2019 (COVID-19) that manifests as an aggressive viral pneumonia, has spread at unprecedented speed and scale resulting in a global pandemic. Despite drastic interventions implemented around the world to contain its spread, COVID-19 has progressed worldwide with significant resultant morbidity and mortality while stretching medical systems to their limits. An exponential increase of COVID-19 cases has also been observed in the USA, with over 200,000 patients confirmed as of 4/1/2020 and rapid daily growth. Thus, efforts are urgently needed to better understand the epidemiology and pathobiology of this illness to limit its impact.</p><p>The overall case fatality rate (CFR) of COVID-19 is estimated to be approximately 3-4%, although large variabilities exist with the highest reported in Italy (11.9%) and the lowest in Germany (1.2%). Early epidemiologic studies emerging from China point to a strong association between advanced age and severity of illness. Similar observations were made in Italy, where up to 20% CFR was noted among patients greater than 80 years old. Numerous important age-associated cardiovascular comorbidities, such as hypertension and coronary heart disease, have also been linked to increased risk for worse outcomes including higher rates of ICU admissions and death. Whether these epidemiological associations are attributed to high risk of infection among the elderly or lesser ability to recover from SARS-CoV-2 infection remain to be clarified.</p><p>In this review, we aim to highlight the pathobiology of SARS-CoV-2 and discuss its potential implications in the cardiovascular system. We then summarize the available epidemiological data with particular attention paid to cardiovascular comorbidities and outcomes. Finally, we discuss various cardiac manifestations of COVID-19.</p>