Respiratory viral infections and their role in human cardiovascular diseases

Acute respiratory viral infections are the most common human diseases. Symptoms of the infection vary from a slight cold to critical condition requiring artificial lung ventilation and support of cardiovascular system. Main risk factors of severe disease include high viral load, co-infection with other pathogens, age from 0 to 2 years and older than 65 years, and immunodeficiency. Cardiac manifestations of the infection are usually caused by indirect effects due to inflammatory reaction resulting in systemic increase in proinflammatory cytokines, so called cytokine storm. However, there have been reports on the identification of respiratory viruses isolated directly from the myocardial tissue, or testing of viral RNA in the myocardium using real-time polymerase chain reaction. This review discusses the direct and indirect effects of respiratory viral infections on causing cardiovascular complications. The authors discuss the similarities and differences of the immunopathogenic mechanisms associated with COVID-19, influenza infection, as well as diseases caused by enteroviruses, respiratory syncytial viruses, metapneumoviruses, and parainfluenza viruses.