Coronavirus Disease 2019 and the Cerebrovascular-Cardiovascular Systems: What Do We Know So Far?

J Am Heart Assoc. 2020 Jul 7;9(13):e016793. doi: 10.1161/JAHA.120.016793. Epub 2020 May 12.


The severe acute respiratory syndrome coronavirus 2 pandemic of 2019 to 2020 has resulted in multiple hospitalizations, deaths, and economic hardships worldwide. Although respiratory involvement in patients with coronavirus disease 2019 (COVID-19) is well known, the potential cardiovascular and cerebrovascular manifestations are less understood. We performed a PubMed and Google Scholar search and reviewed relevant literature on COVID-19 and cardiovascular system involvement. Severe acute respiratory syndrome coronavirus 2 possesses high affinity for angiotensin-converting enzyme 2 receptor, which is highly concentrated in the lungs and cardiovascular tissue, thereby provoking concern for cardiovascular involvement in COVID-19 cases. Preexisting cardiovascular and cerebrovascular disease has been shown in previous reports to be a risk factor for severe infection. On the basis of our review of published studies, COVID-19 patients may be more likely to experience acute cardiac injury, arrhythmia, coagulation defects, and acute stroke and are likely to have poorer outcomes as a result. As the COVID-19 pandemic continues, more data about potential cardiovascular and cerebrovascular manifestations of the disease are required.

Keywords: COVID‐19; SARS‐CoV‐2; cardiac disease; cerebrovascular disease/stroke; coronavirus; vascular disease.

Publication types

  • Review

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Cardiovascular Diseases / epidemiology*
  • Cerebrovascular Disorders / epidemiology*
  • Comorbidity
  • Coronavirus Infections / epidemiology*
  • Global Health
  • Humans
  • Pandemics*
  • Pneumonia, Viral / epidemiology*
  • Risk Factors
  • SARS-CoV-2