Ogeng'o Julius, Karau Paul Bundi, Misiani Musa, Cheruiyot Isaac, Olabu Beda, Kariuki Brian Ngure
Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi, Kenya.
Department of Internal Medicine, School of Medicine, Kenya Methodist University, Meru, Kenya.
Pan Afr Med J. 2020 Jul 21;35(Suppl 2):120. doi: 10.11604/pamj.supp.2020.35.24762. eCollection 2020.
The coronavirus disease 2019 (COVID-19), first reported in Kenya on March 13, 2020, is spreading rapidly. As of 30th June 2020, over 6,190 cases had been reported with a case fatality of 3.2%. Previous Coronavirus outbreaks have been associated with a significant burden of Cardiovascular disease. For COVID-19, however, there has been no direct reference to potential long-term cardiovascular effects, especially in Africa where atherosclerotic diseases are an emerging challenge. This article, therefore, aims at describing possible long-term effects on the burden of atherosclerotic disease among Kenyans. Available data indicate that COVID-19 and cardiovascular disease share pathomechanisms and risk factors which include ACE2 receptor invasion and renin-angiotensin system signaling, oxidative stress, systemic inflammation, and endothelial dysfunction. Further, SAR-COV-2 infection causes dyslipidemia, dysglycemia, kidney, and liver disease. These mechanisms and diseases constitute risk factors for the initiation, progression, and complications of atherosclerosis. In Kenya, the common risk factors for atherosclerotic cardiovascular disease, and COVID-19 comprising Hypertension, Diabetes Mellitus, Obesity, Cigarette Smoking, Respiratory Tract Infections, Pulmonary Thromboembolism, Chronic Obstructive Pulmonary Disease, and Renal disease are not uncommon and continue to increase. In essence, the prevalence of the common risk factors/comorbidities, between COVID-19 and CVD occurrence of ACE2 receptors on the endothelium, and hence pathomechanisms of SARS-COV-2 infection imply that COVID-19 may increase the burden of atherosclerotic disease in Kenya. All due care should be taken, to prevent and effectively manage the disease, to avert an imminent epidemic of atherosclerotic disease.
2019年冠状病毒病（COVID-19）于2020年3月13日在肯尼亚首次报告，目前正在迅速传播。截至2020年6月30日，已报告6190多例病例，病死率为3.2%。先前的冠状病毒爆发与心血管疾病的重大负担有关。然而，对于COVID-19，尚未直接提及潜在的长期心血管影响，尤其是在动脉粥样硬化疾病成为新挑战的非洲地区。因此，本文旨在描述对肯尼亚人动脉粥样硬化疾病负担可能产生的长期影响。现有数据表明，COVID-19与心血管疾病具有共同的病理机制和风险因素，包括ACE2受体侵袭和肾素-血管紧张素系统信号传导、氧化应激、全身炎症和内皮功能障碍。此外，SARS-CoV-2感染会导致血脂异常、血糖异常、肾脏和肝脏疾病。这些机制和疾病构成了动脉粥样硬化发生、发展和并发症的风险因素。在肯尼亚，动脉粥样硬化性心血管疾病和COVID-19的常见风险因素包括高血压、糖尿病、肥胖、吸烟、呼吸道感染、肺血栓栓塞、慢性阻塞性肺疾病和肾脏疾病并不罕见，且呈持续上升趋势。从本质上讲，COVID-19与心血管疾病发生之间常见风险因素/合并症的流行情况以及内皮细胞上ACE2受体的情况，进而SARS-CoV-2感染的病理机制表明，COVID-19可能会增加肯尼亚动脉粥样硬化疾病的负担。应采取一切适当措施预防和有效管理该疾病，以避免即将出现的动脉粥样硬化疾病流行。
