COVID-19 and cardiovascular disease: Clinical implications of biochemical pathways

Coronavirus disease of 2019 (COVID-19) is a viral pandemic which has taken away more than over 4 million lives all over the world as of July 9, 2021, with the USA, India, and Brazil being the most affected countries. Apart from the respiratory tract, the cardiovascular (CV) system is one of the important organ systems affected by this complex multisystem disease. Various studies have confirmed that COVID-19 predisposes an individual to increased risk of CV complications. In fact, hospitalized patients have been consistently reported to have modulated levels of biomarkers demonstrating coagulation and acute cardiac injury. Understanding of molecular mechanisms underlying CV involvement is strongly believed to be the foundation for developing strategies for early diagnosis and management of COVID-19-affected individuals. We review here various molecular mechanisms underlying CV involvement in COVID-19 and discuss several biochemical prognostic markers, as they have evidently revealed their importance in predicting severe prognosis such as mortality, mechanical ventilation, and ICU admission among severe acute respiratory syndrome coronavirus 2-infected patients with or without previous history of myocardial injury. The therapeutic strategies that could be employed to treat and manage CV manifestations in COVID-19-positive individuals are also discussed.