Now a day novel coronavirus is a severe problem all over the world. Currently, SAR-CoV2 was originated. It was an emerging virus. This new strain of coronavirus was introduced on 14 December 2020. This type of mutated stain may produce server illness and even death. These viral spikes will bind with the angiotensin-converting enzymes. Many clinical studies show the association between cardiovascular diseases and COVID-19. It increases the mortality rate. It also increases the risk of injury in myocardial, acute coronary syndromes, and thromboembolism. COVID-19 has produced some risk factors like age and gender, comorbidities, etc. Coronavirus diseases may pose challenges for oncology patients. In cancer patients severe respiratory and systemic infections are shown in immunosuppressed and aging patients. Cancer aggravation is the prognosis of COVID-19 linked to an inflammatory burst and lymphopenia. Here we discussed the risk factors in COVID-19 transmission, aggravates, and clinical interactions between the cardiovascular system. Some drugs are been interacted with the disease it affects the patients.
KEYWORDS: COVID-19, risk factors, risk factors in cancer and cardiovascular to COVID-19
In December 2019, Wuhan, China was the first reported coronavirus disease. It spread all over the world and become a global pandemic. It affects around every country in the world. It affects unprecedented public health. It also affects social and economic activity. The patience of COVID-19 is increased day by day over the last 6 months around the world. There is no prevention is available across the world. The genus beta coronavirus mainly caused the COVID-19. The other two coronaviruses are also caused by the pandemic situations in the world which are (SAR-COV) severe acute respiratory coronavirus and (MERS-CoV) middle east respiratory syndrome coronavirus. COVID-19 causes respiratory infection. It also shows pneumonia and acute respiratory distress syndrome (ADRs). These coronaviruses may trigger cytokine storms like tumor necrosis, IL-β, IL-6, etc. which may release by the immune system and it can form multiorgan failure. These may form coagulations in a proportional substantial in patients. It can form thromboembolic events. The biological features show that 79.6% of genomic sequences is been identified. It shows that both the diseases may enter the body in the same way and it may trigger the binding of viral spike (S) protein to ACE2 in the host cells. Clinical data shows that the susceptibility to the COVID-19 is strongly associated the cardiovascular diseases. These may observe in many COVID-19 patients and it may increase the comorbidities and mortality rate. It also forms myocardial injury, acute coronary syndrome, and thromboembolism. Children have also been affected by COVID-19. It forms hyperinflammatory shock. It also has cardiac dysfunction and coronary vessel abnormalities. It shows bidirectional interaction between the cardiovascular system and COVID-19. This mechanism is elusive. de novo cardiovascular damage is developed in subclinical disorder. For the virus entry ACE2, surface protein plays a most important role. RAAS (renin-angiotensin-aldosterone system) also shows the interaction. Pathophysiology plays a most important role in the development of therapies. Around 45 to 50 million coronavirus cases are crossed. It may kill around 1.2 to 1.5 million people. Dyspnea, respiratory frequency, blood oxygen saturation, and arterial pressure symptoms are also seen in patients. Some cases of COVID-19 may show respiratory failure and mechanism ventilation, shocks, and coagulopathy. Immunopathology is helpful for the identification of clinician patients who shows a higher risk and it may require prioritized treatment for the progression and adverse outcome. In demographic risk factors age, sex, and ethnicity complication play an important role. Some risk factor is been shown to be the high risk of illness. The cellular serine protease (TMPRSS2) is been formed. These are implicated in cancer and viral infections. the ACE2 is been expressed in alveolar cell type 2. It also presents on endothelial and smooth muscle cells. The paucisymptomatic and asymptomatic show a substantial fraction in COVID-19 with comorbidities. It shows acute respiratory failure, cytokine storm, prothrombotic, organ dysfunction, and death. Cancer patients have more susceptible to COVID-19 as compared to non-cancer patients. Cancer risk factors show a high prevalence of COVID-19. CT (computed tomography) is used for metabolic disorders. Some countries have patient which is diagnosed with cancer and have a small amount of COVID-19 infections. cancer prevalence is not associated with infection risk. Lung carcinoma is been shown in CT scan manifestations. Gender shows the main risk factor in the population. Obesity and congestive heart failure are one of them. For the association of COVID-19 race and ethnicity also play a most important role. Hispanic and black people are most affected by this disease. Veneto region shows a higher number of COVID-19 patients and death. The hematology lungs and breast cancer show the more vulnerable as compared to cancer patients. Coronavirus mostly affected lung cancer patients. For this type of person, coronavirus shows more infections. severity is for pulmonary disease patients. The comorbidities is been increased for former smokers and chemotherapy patients. At older age the hematological malignancies were diagnosed as myeloid leukemia and plasma cell neo plasma was associated with worse. The more susceptible patients with metastatic or stage IV carcinomas is been diagnosed with COVID-19. The severity of the cancer treatment is been contributed to the cancer patient. In the multivariant analysis of patients, the age and receipt of immune inhibitor treatment is been associated with COVID-19 patients. In this only 2.5% of patients is been seen as positive. Age is the most important factor in COVID-19 patients. It was not clear whether the cancer is a more risk factor or the cancer-associated risk depends on demography. Cancer diagnosis and COVID-19 are more dangerous to the risk of death. The cancer cohorts are well described in the meta-analysis of COVID-19 patients.
Genomic sequencing is done for the understanding of COVID-19 characteristic features. These may help to evaluate the structure of the viral protein. The family from which the coronavirus has belonged is the single-stranded RNA enveloped. These are highly pathogenic for human beings. MERS-COV is also a highly pathogenic coronavirus. Both this coronavirus originated from bats. These are the natural reservoir. The SARS-COV-2 is 80% similar with SARS-CoV and 97% similar with bat coronavirus (RaTG13). By the homology of genomic sequences, the biological features are similar to SARS-CoV. For entry into the host cells ACE2 receptor is been used by both infections. in MERS-CoV dipeptidyl peptidase s been used. The crown-like structure is formed which contains four types of proteins known as (S) spike, (E) envelope, (M) membrane, and a (N) nucleocapsid. N proteins surround the viral genome in a positive sense. Both genome and mRNA function as single-stranded rRNA. α, β, γ and δ is shown in coronavirus. Only α and β coronavirus is infected humans. Beta coronavirus is the genus from which the SARS-CoV, MERS-CoV and SARS-CoV-2. The genome sequence of COVID-19 is 30kb in length and contains ORFs (open reading frames) it is used for the encoding of 24-27 genes. Pp1a and pp1ab polyproteins encode the 5’ terminal of two-thirds of the genome. These may leave the 16 non-structural proteins like RNA-dependent and RNA polymerase. The 3′-terminal encoded the structural proteins [S, E, M, and N] of one-third of the genome. The S protein is used for the pivotal roles in virus attachment and pathogenesis. In both coronaviruses S protein triggers the ACE2 into the host cells. For the development of vaccines, the S proteins, and ACE2. It is also used in the formation of antibiotics and antiviral drugs. S proteins are similar in both coronavirus infections. it contains 73 to 76% of whole proteins. 50 to 60% of receptor-binding domain and motif. The S protein which is present in the new coronavirus is different from the old one. These show the high binding affinity to ACE2 receptors. The 5 to 6 residues are bound to the receptor-binding motif. Mutation of ACE2 in S proteins. S protein binds directly to the ACE2 receptor. These are shown by cryogenic electron microscopy. It has a higher affinity in COVID-19. High binding is been related to the high severity and transmissibility of COVID-19. 12 nucleosides are been inserted into the S proteins. It forms a novel furin cleavage site. These are not originated in the COVID19. Their functions are also unknown. These are also found in the influenza virus and in Newcastle disease virus. These are used for expanding the cells and tissue tropism in COVID-19 and it also affects the multiorgan.