One study showed the presence of the virus in the vessel wall, indicating direct infection ( 4) this also has been seen in other infectious diseases. COVID-19 is more aggressive than previous viral respiratory diseases, and systemic manifestations are expected to be more severe. Stroke has also been reported as a result of large-vessel occlusion in young patients with COVID19 – one more aspect of the conundrum that is being studied during this pandemic. They are associated with a significant increase in the risk of all-cause mortality ( 3). Myocardial infarction and myocarditis have been described in 20-30% of patients hospitalized for COVID-19. Myocarditis, mediated by cytokines caused by a direct effect of the virus on myocytes, has also been described. Influenza also affects the incidence of stroke in hypertensive patients. The impact on mortality is alleviated by vaccine immunization. In the case of influenza infection, the prevalence of myocardial infarction and associated mortality rates is higher among patients ≥65 years of age. It is known to be mediated by cytokines and has been shown to occur in pneumonia caused by influenza ( 1, 2).

Arterial and venous thrombosis have been noted in necropsy studies, suggesting a direct and/or indirect action of the virus on the endothelium and the coagulation cascade.Įndothelial involvement in bacterial and viral infections is not a new finding. It affects mainly the lungs, but its effects on other organs can reflect the severity of sepsis in a patient. COVID-19 is a respiratory disease that causes severe pneumonia and sepsis.

The Two Chambers by Pedro Puech