Combating COVID-19 For Human Cardiovascular Health
Generally, it was originally expected that the COVID-19 pandemic would become an “old” after 2020. However, since there are new variants of SARS-CoV-2 in over 100 countries, current status of COVID-19 will change our expectation due to increases in the infectivity and uncertainty. Some locals had to be “lockdown” once again, and more subjects could have “atrial fibrillation” and their cardiac cells may suffer from unexpected injuries. In fact, due to obvious delayed diagnosis and treatment during the COVID-19 pandemic, there is an increase in the number of deaths among patients with major non-communicable diseases (mNCDs), such as cardiovascular disease (CVD), diabetes, and cancer, due to major adverse cardiocerebrovascular events (MACCE), such as cardiac injury (8) and cardiac arrest (9), and higher mortality rate (10).
Currently, COVID-19 had already been a high risk factor of MACCE and cardiovascular outcomes (11). Moreover, there is a further increase in the prevalence of stress, anxiety, depression among the general population. Hence, it indeed needs benefit–risk evaluations of COVID-19 control measures on short-term and long-term health outcomes. Actually, keeping away from COVID-19 cases and avoiding SARS-CoV-2 infection is to protect individuals’ cardiovascular system.
The variants of SARS-CoV-2 in countries worldwide indeed increase local bio-hazard, and there are growing concerns whether current vaccines can provide effective protection since novel spike mutants can yield antibody resistance or variants became resistant to some neutralizing antibodies (12, 13). Traditional vaccines are based on live attenuated or inactivated pathogens, there are many novel vaccines based on DNA, RNA, recombinant protein, recombinant virus, and peptides due to new concepts and technologies in vaccine design.
However, there are still no clear recommendations or a consensus on the developed SARS-CoV-2 vaccines and it is still a considerable risk for individuals who receive a SARS-CoV-2 vaccine (14). Due to the rapid variation of COVID-19, the traditional single dose vaccination has been unable to achieve the expected clinical effect of whole immunity, and the effect of multi-needle vaccination is still uncertain. This further confirms the great significance of positive conduction of the “ISISI” barriers from locals or regions to the globe (Fig. 1) [Isolation; Screening and testing; Individual immunity by a healthy lifestyle, bio-agents, and vaccination; Social and medical supports; International cooperation & information sharing] during the pandemic and post-COVID-19 era.
For example, isolation (social restrictions) is enough effective to contain the pandemic, but without negatively impact even if there is a normal population response to a stressful situation (15). At the same time, active and positive screening of SARS-CoV-2 infection and biomarkers of COVID-19 cases is a determined protective measure. For example, low-spike antibody levels of anti-SARS-CoV-2 predict mortality in critical COVID-19 (16). High lipoprotein(a) is a strong risk factor for ischemic heart disease in COVID-19 cases (17).
Then, can existing and developing vaccines help to end the COVID-19 pandemic in 2022? Will the global pandemic return to its peak due to Delta and Omicron? In fact, there are not yet solid data exist on the infectivity of those who have been vaccinated and how long the vaccine protects against COVID-19. As a preventive and therapeutic strategy for COVID-19, vaccines with high-quality should be safe, immunogenic and stable, and less allergic reactions (18), with a higher neutralizing capacity and a longer duration of immunity (19), a rational price, easy to delivery and rollout with robust equity, and suitable for all ages, and there are pre-existing T cell responses after vaccination in unexposed individuals as COVID-19 convalescent cases (20).
There is the unique pathogenesis of SARS-CoV-2 infection in cardiomyocytes due to those host-virus interactions (21), IL-1β blockade or IL-1β-neutralizing therapies during COVID-19 infection may protect those patients at higher risk of cytokine storm (22). And an innovative, safe, and rapid detection by 18F-FDS PET/CT is available for clinical applications in hospitalized patients with COVID-19 (23). All in all, we expect getting final victory by effective vaccinations as a vital strategy against COVID-19 so as to better protect human cardiovascular health. Fortunately, a recent study showed that three-dose vaccination elicits neutralizing antibodies against the omicron variant of SARS-CoV-2 infection (24).