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).