Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Cardiovascular Vulnerability to COVID-19 in Cancer Survivors

Version 1 : Received: 7 April 2020 / Approved: 8 April 2020 / Online: 8 April 2020 (11:49:56 CEST)

How to cite: Zordoky, B. Cardiovascular Vulnerability to COVID-19 in Cancer Survivors. Preprints 2020, 2020040128. Zordoky, B. Cardiovascular Vulnerability to COVID-19 in Cancer Survivors. Preprints 2020, 2020040128.


Coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization on March 11, 2020. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2). Although primarily a respiratory disease, cardiovascular complications of COVID-19 have been increasingly recognized. In addition, higher fatality has been reported in COVID-19 patients with underlying cardiovascular diseases. Cancer survivors have a considerably increased risk for premature cardiovascular diseases, mainly due to cardiotoxic cancer treatments. Therefore, it is foreseeable that cancer survivors will be more vulnerable to cardiovascular complications caused by COVID-19. In this review, three scenarios for increased cardiovascular complications of COVID-19 in cancer patients are proposed. In the first scenario, cardiotoxic cancer treatment and COVID-19 synergize to exacerbate direct myocardial damage. In the second scenario, cardiotoxic cancer treatment leads to a reduced cardiac reserve in cancer survivors, making them more vulnerable to COVID-19 in a “two-hit” model. The third scenario suggests that several shared risk factors may aggravate cardiovascular complications caused by both cancer treatment and COVID-19. Taken together, cancer survivors may be more vulnerable to cardiovascular complications when challenged by the COVID-19, and special cardiovascular care should be given to these patients.


COVID-19; Cancer Survivors; Cardiovascular


Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Comments (1)

Comment 1
Received: 12 April 2020
The commenter has declared there is no conflict of interests.
Comment: Excellent topic. Take in consideration ACE2, the cell receptor that SARS-Cov2 binds to enter human cells, is highly expressed in heart and kidney. Recent reports indicated sudden cardiac death as a potential complication from COVID-19. Currently, we do not know if this is due to complications from the disease itself (viral myocarditis) or from the medications used e.g. hydroxychloroquine. Interesting topic. look forward to reading it and let me know if you need any help.

Mohammad Ali
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