Resident, Department of Internal Medicine, St Vincent Hospital, 123 summer street, Worcester, MA, USA.
Resident, Department of Internal Medicine, St Vincent Hospital, 123 summer street, Worcester, MA, USA.
Heart Lung. 2020 Nov-Dec;49(6):848-852. doi: 10.1016/j.hrtlng.2020.04.019. Epub 2020 May 3.
Coronavirus disease (COVID-19) pandemic has so far involved 184 countries and more than 2.79 million patients worldwide. Over the past three months, it has attributed to more than 196,000 deaths, with more than 50,000 deaths in the United States alone. Pulmonary manifestations are predominant and have been well identified. Cardiac involvement is also common. Acute cardiac injury, the most common cardiac manifestation of this disease can be seen in patients even without prior cardiac comorbidities. Established cardiovascular risk factors such as diabetes mellitus, hypertension, and coronary artery disease predispose to cardiac injury, the severity of illness and mortality. Non-ischemic myocardial injury secondary to cytokine storm is thought to be the predominant mechanism of acute cardiac injury associated with COVID-19. Multiple mechanisms and processes contribute to cardiac injury resulting in a poor outcome. Some of these are not clearly understood. Clinical and diagnostic details of cardiovascular involvement in these patients are mostly limited to biochemical markers. Multiple therapeutic agents have been tried with questionable efficacy and without clinical evidence. Interactions of comorbidities, cardiovascular drugs, the cardiac effect of therapeutic agents on the illness continue to be under investigation. With an increasing number of patients, newer promising therapies, and ongoing clinical trials, the exact mechanisms and extent to which these risk factors contribute to outcomes will be clearer in the future.
冠状病毒病（COVID-19）大流行迄今已涉及 184 个国家和全球超过 279 万例患者。在过去的三个月中，它导致超过 196,000 人死亡，仅美国就有超过 50,000 人死亡。肺部表现为主，已得到充分确认。心脏受累也很常见。急性心脏损伤是这种疾病最常见的心脏表现，即使没有先前的心脏合并症，患者也会出现这种情况。已确定的心血管危险因素，如糖尿病，高血压和冠状动脉疾病，易导致心脏损伤，疾病的严重程度和死亡率。细胞因子风暴引起的非缺血性心肌损伤被认为是与 COVID-19 相关的急性心脏损伤的主要机制。多种机制和过程导致心脏损伤，从而导致不良预后。其中一些尚不清楚。这些患者心血管受累的临床和诊断细节主要限于生化标志物。已经尝试了多种治疗药物，但疗效可疑，没有临床证据。合并症，心血管药物之间的相互作用，治疗药物对疾病的心脏作用仍在研究中。随着越来越多的患者，新的有前途的治疗方法和正在进行的临床试验，这些危险因素在多大程度上对结果产生影响的确切机制将在未来更加清楚。
