Figure 1.

COVID-19 and the cardiovascular (CV) system. The initial step of disease begins with SARS-CoV-2 infection in the upper respiratory system, which leads to fever or cough as the main symptomatology. Then, in some cases, viral infection leads to lung injury characterized by dyspnea, lung inflammation, and pneumonia, with or without associated hypoxia. Later on, if the infection progress, the acute respiratory distress syndrome (ARDS) and extrapulmonary manifestations can appear. Systemic and local hyperinflammation may provoke endothelial dysfunction, vascular permeability, thrombogenesis, and altogether, acute cardiac injury characterized by arrhythmias, acute coronary syndrome, or type-2 myocardial infarction. Also, in COVID-19 subjects, diverse underlaying comorbidities, such as hypertension, coronary artery disease (CAD), and obesity, could accelerate these events. In addition, CV cells may be directly infected by viral particles, reinforcing myocarditis and vasculitis processes. ARDS and CAD stand for acute respiratory distress syndrome and coronary artery disease, respectively.