The coronavirus disease 2019 (COVID-19) pandemic exposes unexpected cardiovascular vulnerabilities and the need to improve cardiometabolic health. Four cardiometabolic drivers—abnormal adiposity, dysglycemia, dyslipidemia, and hypertension—are examined in the context of COVID-19. Specific recommendations are provided for lifestyle change, despite social distancing restrictions, and pharmacotherapy, particularly for those with diabetes. Inpatient recommendations emphasize diligent and exclusive use of insulin to avert hyperglycemia in the face of hypercytokinemia and potential islet cell injury. Continuation of statins is advised, but initiating statin therapy to treat COVID-19 is as yet unsubstantiated by the evidence. The central role of the renin-angiotensin system is discussed. Research, knowledge, and practice gaps are analyzed with the intent to motivate prompt action. An emerging model of COVID-related cardiometabolic syndrome encompassing events before, during the acute phase, and subsequently in the chronic phase is presented to guide preventive measures and improve overall cardiometabolic health so future viral pandemics confer less threat. Central Illustration Highlights • COVID-19 exposes epidemiological and mechanistic relationships with cardiometabolic links (abnormal adiposity, dysglycemia, dyslipidemia, and hypertension). • Lifestyle, glycemic control, and regulation of the RAS have important implications for management of patients with COVID-19. • CIRCS applies to all stages of COVID-19 illness, including prevention, acute management, and long-term outcomes. • Further research should address gaps in current knowledge and clinical implementation of available strategies to mitigate the adverse consequences of CIRCS.
【저자키워드】 COVID-19, SARS-CoV-2, lifestyle, obesity, COVID-19, Coronavirus disease 2019, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, cardiovascular disease, prevention, diabetes, hypertension, angiotensin-converting enzyme 2, chronic disease, Adiposity, statin, lipids, dyslipidemia, cardiometabolic, dysglycemia, BMI, Body mass index, ICU, Intensive care unit, RAS, Renin-angiotensin system, CIRCS, coronavirus disease–related cardiometabolic syndrome, CMBCD, cardiometabolic-based chronic disease, HCP, health care professional,