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用于治疗新冠病毒 19 所致心脏损伤的药物制剂。

Pharmacological agents to therapeutic treatment of cardiac injury caused by Covid-19.

作者信息

Vitiello A, Ferrara F

机构信息

Pharmaceutical Department, Usl Umbria 1, A. Migliorati street, 06132 Perugia, Italy.

出版信息

Life Sci. 2020 Dec 1;262:118510. doi: 10.1016/j.lfs.2020.118510. Epub 2020 Sep 28.

Abstract

SARS-CoV-2 is responsible for the 2019 coronavirus disease (COVID-19), a global pandemic that began in March 2020 and is currently in progress. To date, COVID-19 has caused about 935,000 deaths in more than 200 countries. The respiratory system is most affected by injuries caused by COVID-19, but other organs may be involved, including the cardiovascular system. SARS-CoV-2 penetrates host cells through the angiotensin 2 conversion enzyme (ACE-2). ACE-2 is expressed not only in the lungs, but also in other organs, including the cardiovascular system. Several studies have found that a good percentage of patients with severe COVID-19 have cardiac lesions, including myocardial fibrosis, edema and pericarditis. Pathological remodeling of the extracellular matrix caused by viral infection leads to myocardial fibrotic lesions. These fibrotic scars can cause cardiac dysfunction, reducing the ejection fraction caused by the presence of stiffened myocardial matrix, or cardiac arrhythmias that cause an alteration in the electrical conduction system of the heart. These cardiac dysfunctions can cause death. It is therefore essential to identify cardiac involvement early in order to act with appropriate therapeutic treatments. In this review, we describe what is known about cardiac injury from COVID-19, highlighting effective pharmacological therapeutic solutions to combat cardiac injury, particularly cardiac fibrosis, caused by COVID-19.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发了2019冠状病毒病(COVID-19),这是一场始于2020年3月且仍在持续的全球大流行。截至目前,COVID-19已在200多个国家造成约93.5万人死亡。呼吸系统受COVID-19所致损伤的影响最为严重,但其他器官也可能受累,包括心血管系统。SARS-CoV-2通过血管紧张素2转换酶(ACE-2)进入宿主细胞。ACE-2不仅在肺部表达,在包括心血管系统在内的其他器官中也有表达。多项研究发现,相当比例的重症COVID-19患者存在心脏病变,包括心肌纤维化、水肿和心包炎。病毒感染导致的细胞外基质病理重塑会引发心肌纤维化病变。这些纤维化瘢痕可导致心脏功能障碍,因心肌基质硬化而使射血分数降低,或引发导致心脏电传导系统改变的心律失常。这些心脏功能障碍可导致死亡。因此,尽早识别心脏受累情况以便采取适当的治疗措施至关重要。在本综述中,我们描述了关于COVID-19所致心脏损伤的已知情况,重点介绍了对抗COVID-19所致心脏损伤,尤其是心脏纤维化的有效药物治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b761/7521881/2f4c4c61936e/ga1_lrg.jpg

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