ABC | Volume 114, Nº5, May 2020

Viewpoint Cardiovascular Implications in Patients Infected with Covid-19 and the Importance of Social Isolation to Reduce Dissemination of the Disease Juliana Alves Costa, 1 J uliana de Almeida Silveira, 1 Sa ra Cristine Marques dos Santos, 1 Patrícia Pereira Nogueira 1 Universidade de Vassouras – Cardiologia,1 Rio de Janeiro, RJ – Brazil Abstract Respiratory symptoms, especially the development of severe acute respiratory distress syndrome, dominate the discussion and initial concerns of the population and health professionals. However, the cardiovascular system is greatly affected by these conditions and is often responsible for complications and mortality of these patients. In order to show the cardiovascular implications in patients infected with COVID-19 and the importance of social isolation as an alternative to curb the spread of the disease, a literature review was carried out based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed. The findings showed that cardiac complications associated with COVID-19 infection are similar to those produced by: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. However, COVID-19 has a much greater and faster contamination and, unlike influenza, there is no vaccine or treatment available yet. In view of this, social isolation becomes a tool that can reduce and flatten the curve of cases and thus protect the people at higher risk, decreasing the chances of serious conditions related to the disease, potential deaths and the collapse of the country’s health system. Introduction Coronavirus is a virus belonging to the Coronaviridae family, causing simple flu to diseases that can cause greater risks to the population’s health. The novel coronavirus, which caused the 2020 pandemic, received the name SARS-CoV-2 by the World Health Organization (WHO), and the disease it causes has the name: COVID-19. 1 It was first detected in December 2019 in Wuhan, China. However, due to its high dissemination power, several countries confirmed the presence of allochthonous cases in mid-January 2020. In Brazil, the first case was confirmed on February 26, 2020. 2,3 Until the appearance of SARS-CoV-2, two other epidemics caused by coronavirus were described: SARS-CoV-1, which causes severe acute respiratory syndrome (SARS), in 2002; and MERS-CoV, which caused the Middle East respiratory syndrome (MERS), in 2012. 4 The pathophysiology of SARS- CoV-2 was similar to that of SARS-CoV-1, as they present acute lung injuries due to the aggressive inflammation initiated by viral replication. SARS-CoV-2 infection can cause increased secretion of pro-inflammatory interleukins and interferon- gamma (IFN- γ ) that cause lung damage. 5 Brazil, like other countries, is going through the process of demographic transition that has the aging of the population as its main effect. Thus, diseases of the circulatory system appear as the main cause of mortality in the population. By associating this information with recent studies of cardiovascular implications and their worsening by SARS-CoV-2, it is evident that prevention and control measures that reduce risks of contamination and infection are important tools in the reduction of severe cases of the disease and potential deaths. This article relates the current pandemic of COVID-19 with the cardiovascular implications, showing the importance of social isolation as a measure to prevent and control the spread of the disease and preserve the country’s Health System. Material and methods Literature review based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed, referring to the cardiovascular implications in patients infected with Covid-19, the importance of social isolation as a measure of prevention and control of disease spread and preservation of the country’s health system. Overview of COVID-19 The COVID-19 pandemic, as well as previous epidemics of other coronaviruses (SARS and MERS) and the 2009 pandemic (H1N1), have serious consequences for the health, economic and social models of the entire world population. Although demographic transition occurs differently from country to country, in general, is characterized by an increase in the elderly population compared to other age groups, as it grows about 4% per year. Factors such as reduced fertility, reduced infant mortality and general mortality, improvements in health care for the population, technological development with regard to the diagnosis and treatment of diseases also corroborate the current demographic scenario. 6 Concomitantly with the increase in the number of elderly people, there is an epidemiological transition, with an increase in the proportion of circulatory diseases, diabetes mellitus, Mailing Address: Juliana Alves Alves Costa • Universidade de Vassouras - Cardiologia Av. Expedicionário Osvaldo de Almeida Ramos, 280. Postal Code 27700-000, Centro, Vassouras, RJ - Brazil E-mail: jujuh.ac@hotmail.com Manuscript received March 24, 2020, revised manuscript April 15, 2020, accepted April 15, 2020 Keywords Coronavirus; COVID-19; Infecções por Coronavirus/ prevention and control; Social Isolation; Diseases Dissemination. DOI: https://doi.org/10.36660/abc.20200243 834