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新型冠状病毒肺炎感染中的心血管影响及治疗考量

Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection.

作者信息

Judson Gregory L, Kelemen Benjamin W, Njoroge Joyce N, Mahadevan Vaikom S

机构信息

Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA.

出版信息

Cardiol Ther. 2020 Dec;9(2):293-305. doi: 10.1007/s40119-020-00184-5. Epub 2020 Jun 13.

Abstract

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has united researchers from bench to bedside in attempts to understand the pathophysiology of the disease and define optimal treatment strategies. Cardiovascular disease is highly prevalent and a leading cause of death across gender, race, and ethnic groups. As the pandemic spreads, there is increasing concern about the cardiovascular effects of the viral infection and the interaction of infection with existing cardiovascular disease. Additionally, there are concerns about the cardiac effects of the numerous treatment agents under study. It will be essential for cardiologists to understand the interplay between underlying cardiac comorbidities, acute cardiovascular effects of COVID-19 disease, and adverse effects of new treatments. Here we describe emerging evidence of the epidemiology of SARS-CoV-2 infection and underlying cardiovascular disease, the evidence for direct myocardial injury in SARS-CoV-2 infection, the specific presentations of cardiovascular involvement by SARS-CoV-2, and the cardiac effects of emerging treatments.

摘要

目前正在肆虐的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行对医学的各个领域都产生了深远影响。感染SARS-CoV-2以及由此引发的2019冠状病毒病(COVID-19)综合征具有多器官影响。这场大流行促使从实验室到临床的研究人员联合起来,试图了解该疾病的病理生理学并确定最佳治疗策略。心血管疾病非常普遍,是不同性别、种族和族裔群体的主要死因。随着大流行的蔓延,人们越来越关注病毒感染对心血管的影响以及感染与现有心血管疾病之间的相互作用。此外,人们还担心正在研究的众多治疗药物对心脏的影响。心脏病专家必须了解潜在的心脏合并症、COVID-19疾病的急性心血管影响以及新治疗方法的不良反应之间的相互作用。在此,我们描述了SARS-CoV-2感染和潜在心血管疾病流行病学的新证据、SARS-CoV-2感染中直接心肌损伤的证据、SARS-CoV-2心血管受累的具体表现以及新出现的治疗方法对心脏的影响。

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