text: Cardiovascular and renal risk factors and complications associated with COVID 19 The current COVID 19 pandemic caused by the SARS CoV 2 virus Severe Acute Respiratory Syndrome Coronavirus 2 represents the largest medical challenge in decades It has exposed unexpected cardiovascular vulnerabilities at all stages of the disease pre infection acute phase and subsequent chronic phase The major cardiometabolic drivers identified to have epidemiological and mechanistic associations with COVID 19 are abnormal adiposity dysglycemia dyslipidemia and hypertension Hypertension is of particular interest because components of the renin angiotensin system RAS which are critically involved in the pathophysiology of hypertension are also implicated in COVID 19 Specifically ACE2 a multifunctional protein of the RAS which is part of the protective axis of the RAS is also the receptor through which SARS CoV 2 enters host cells causing viral infection Cardiovascular and cardiometabolic co morbidities not only predispose to COVID 19 but are complications of SARS CoV 2 infection In addition increasing evidence indicates that acute kidney injury is common in COVID 19 that it occurs early and in temporal association with respiratory failure and is associated with poor prognosis especially in the presence of cardiovascular risk factors Here we discuss cardiovascular and kidney disease in the context of COVID 19 and provide recent advances on putative pathophysiological mechanisms linking cardiovascular disease and COVID 19 focusing on the RAS and ACE2 as well as the immune system and inflammation We provide up to date information on the relationship between hypertension diabetes and COVID 19 and emphasize the major cardiovascular diseases associated with COVID 19 We also briefly discuss emerging cardiovascular complications associated with long COVID 19 notably postural tachycardia syndrome POTS 