Cardiovascular diseases and obesity: The concise systematic review in the context of SARS-CoV-2

Introduction: COVID-19 disease is associated with vascular inflammatory processes, myocarditis, and cardiac arrhythmias, worsening CVD, diabetes, and hypertension. In this scenario, SARS-CoV-2 is worsening the comorbidities of obesity. Objective: To conduct a summary systematic review on the main relationships of COVID-19 with cardiovascular diseases and obesity, highlighting the main physiometabolic and pathological mechanisms. Strategy: The search strategy was carried out in the PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus databases. After a complete analysis of these selected studies, in the scenario of cardiovascular diseases (CVD), obesity initially favors the development of inflammation in adipose tissue, by increasing the production of pro-inflammatory adipokines. Metainflammation leads to myocardial dysfunction by direct injury to inflammatory mediators, as well as by dysfunction to other organs. Thus, the endothelial dysfunction caused by SARS-CoV-2 justifies blood vessel-related comorbidities such as cardiovascular disease, hypertension, diabetes, and obesity are more likely to develop severe COVID-19. Conclusion: COVID-19 disease is associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Cardiovascular disease and pharmacological inhibition of COVID-19 increase ECA2 levels, which can increase the virulence of the coronavirus in the lung and heart. Also, obesity is an important predictor of worsening SARS-CoV-2 pathology.