COVID-19 and Cardiovascular Health Among Patients with Cancer
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CARDIO-ONCOLOGY (T NEILAN, SECTION EDITOR)
COVID-19 and Cardiovascular Health Among Patients with Cancer Nicolas L. Palaskas 1
&
Efstratios Koutroumpakis 2 & Anita Deswal 1
Accepted: 9 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of review The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread with rising new cases and deaths. Patients with cancer represent a uniquely vulnerable population not only with higher susceptibility to COVID-19 but also at increased risk for its complications. This review focuses on the implications of COVID-19 in the cardiovascular health of patients with cancer. Recent findings Patients more susceptible to COVID-19 with increased severity of disease include those with cancer and cardiovascular comorbidities. In addition, the cardiovascular complications of COVID-19 including acute myocardial injury, thromboembolism, cardiomyopathy, myocarditis, and pericardial disease overlap with many of those encountered during cancer treatment. Summary Despite the absence of large studies of patients with both cancer and cardiovascular disease, the incidence of cardiovascular complications in cancer patients with COVID-19 is expected to be high. This has implications for cardiac monitoring, chemotherapy administration, and the diagnosis and treatment of cardiovascular disease during COVID-19. Keywords Coronavirus . Cardiovascular . Cancer . COVID-19
Introduction Since its emergence from Wuhan, China, in December of 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the globe with 13 million confirmed cases and more than 570,000 deaths as of July 14, 2020 [1]. Multiorgan involvement, including cardiovascular system manifestations, has been associated with the novel coronavirus disease 2019 (COVID-19) or its treatment [2, 3]. Acute myocardial injury, acute myocarditis, arrhythmias, and thromboembolic events have all been observed This article is part of the Topical Collection on Cardio-Oncology * Nicolas L. Palaskas [email protected] Efstratios Koutroumpakis [email protected]
during COVID-19 infection [4–6]. The early experiences from China suggest that some patient characteristics (e.g., age, gender, pre-existing disease conditions including cardiovascular disease and cancer) as well as exposure to certain medications increase an individual’s risk of COVID-19-related adverse outcomes [2]. Patients with cancer represent a unique population during the era of COVID-19 pandemic, not only because of their susceptibility to infections in the setting of a compromised immune system but also due to their already elevated risk for thromboembolic events, myocarditis in the setting of treatment with immune checkpoint inhibitors, and QT prolongation related to cancer therapeutics, all of which also represent known complications of COVID-19 and its treatment (Fig. 1). In the current review, we
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