Introduction
The spread of COVID-19, a disease caused by the infection with the
SARS-CoV-2, has reached pandemic proportions and dramatically impacted
public health and the global economy. As of June 15, 2020, more than 7.5
million people have been infected worldwide, and more than 400,000 died.
Most COVID-19 patients suffered from lung damage, but the virus has been
shown to affect other systems as well. The angiotensin-converting enzyme
2 (ACE2) receptor plays a vital role in the infection of cells by the
SARS-CoV-2 [1]. Although myocardial cells express ACE2 receptors,
myocardial biopsies and autopsy of COVID-19 patients did not reveal
significant heart damage caused by a viral infection. Despite the
absence of sufficient evidence in the cardiac autopsy reports, various
findings indicate that in some clinical cases, the virus may not
directly attack the myocardial cells, but affect the function of the
heart through alternative mechanisms. Given the paucity of reports on
cardiac pathology in COVID-19, the direct impact of the virus on the
heart remains unclear.
Previous studies have demonstrated a close connection between the brain
and the heart, but the possibility of an interaction between these two
organs in COVID-19 patients has not been raised thus far. Therefore, we
would like to advance the hypothesis that that COVID-19 may affect the
function of the heart through the interaction between the brain and the
heart. We hope that this analysis will provide new ideas for research
and suggest treatment methods that could be applied clinically.