Defining the role of hypertension in SARS-CoV-2 mediated cardiovascular pathology

Heart failure is a complex and progressive condition that is currently on the rise in Canada. Despite advances in treatment options, mortality remains significantly high due to our limited understanding of the disease. A major risk factor for developing heart failure is hypertension, which is present in up to 90% of heart failure patients. However, not everyone with hypertension will develop heart failure (around 30%). This suggests that unknown additional factors are promoting heart failure in people with hypertension. Viral infection is a major risk factor for developing heart failure, including infection with respiratory viruses like SARS-CoV-2. Over the course of the COVID-19 pandemic, cardiac complications have been reported as common long-term consequences of SARS-CoV-2 infection. Previous diagnosis with cardiovascular disease, particularly hypertension, strongly associates with worse COVID-19 disease outcomes. How SARS-CoV-2 induces cardiac injury and whether this injury is amplified in people with hypertension is unknown. We found that infecting Hamsters with SARS-CoV-2 promoted injury to heart tissue and caused immune cells to accumulate in the heart. These findings show that SARS-CoV-2 is causing injury to the heart but whether this damage is being directly caused by the virus or indirectly by the immune system is unknown. We propose to first define how SARS-CoV-2 is causing cardiac injury. Secondly, we plan to cause chronic hypertension in hamsters and determine whether hypertension can promote cardiac damage caused by SARS-CoV-2. The work proposed here may provide insight on how two risk factors for heart failure, hypertension and viral infection, are interacting. Furthermore, we may uncover how SARS-CoV-2 is causing cardiac injury and uncover new treatment options to prevent injury.