Microvascular disease confers additional risk to COVID-19 infection

Med Hypotheses. 2020 Nov:144:109999. doi: 10.1016/j.mehy.2020.109999. Epub 2020 Jun 15.

Abstract

The majority of fatalities thus far in the COVID-19 pandemic have been attributed to pneumonia. As expected, the fatality rate reported in China is higher in people with chronic pulmonary disease (6.3%) and those who have cancer (5.6%). According to the American College of Cardiology Clinical Bulletin "COVID-19 Clinical Guidance for the CV Care Team", there is a significantly higher fatality rate in people who are elderly (8.0% 70-79 years; 14.8% ≥80 years), diabetic (7.3%), hypertensive (6.0%), or have known cardiovascular disease (CVD) (10.5%). We propose a biological reason for the higher mortality risk in these populations that is apparent. We further present a set of pathophysiological reasons for the heightened danger that could lead to therapies for enhanced management and prevention.

Keywords: COVID-19; Innate immunity; MPO; Microvascular disease.

MeSH terms

  • Adult
  • Aging / immunology
  • COVID-19 / epidemiology*
  • COVID-19 / etiology
  • COVID-19 / immunology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / immunology
  • Child
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / immunology
  • Disease Susceptibility
  • Humans
  • Hydrogen Peroxide / metabolism
  • Hypertension / epidemiology
  • Hypertension / immunology
  • Hypochlorous Acid / metabolism
  • Immunity, Innate*
  • Lung / blood supply
  • Lung / immunology
  • Microcirculation
  • Microvessels / physiopathology
  • Neutrophils / immunology
  • Neutrophils / metabolism
  • Pandemics*
  • Peroxidase / metabolism
  • Risk Factors
  • United States / epidemiology

Substances

  • Hypochlorous Acid
  • Hydrogen Peroxide
  • Peroxidase