Quagliariello Vincenzo, Bonelli Annamaria, Caronna Antonietta, Conforti Gabriele, Iovine Martina, Carbone Andreina, Berretta Massimiliano, Botti Gerardo, Maurea Nicola
Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy.
Department of Medical Oncology-Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy.
Cancers (Basel). 2020 Nov 10;12(11):3316. doi: 10.3390/cancers12113316.
The coronavirus disease-2019 (COVID-19) is a highly transmissible viral illness caused by SARS-CoV-2, which has been defined by the World Health Organization as a pandemic, considering its remarkable transmission speed worldwide. SARS-CoV-2 interacts with angiotensin-converting enzyme 2 and TMPRSS2, which is a serine protease both expressed in lungs, the gastro-intestinal tract, and cardiac myocytes. Patients with COVID-19 experienced adverse cardiac events (hypertension, venous thromboembolism, arrhythmia, myocardial injury, fulminant myocarditis), and patients with previous cardiovascular disease have a higher risk of death. Cancer patients are extremely vulnerable with a high risk of viral infection and more negative prognosis than healthy people, and the magnitude of effects depends on the type of cancer, recent chemotherapy, radiotherapy, or surgery and other concomitant comorbidities (diabetes, cardiovascular diseases, metabolic syndrome). Patients with active cancer or those treated with cardiotoxic therapies may have heart damages exacerbated by SARS-CoV-2 infection than non-cancer patients. We highlight the cardiovascular side effects of COVID-19 focusing on the main outcomes in cancer patients in updated perspective and retrospective studies. We focus on the main cardio-metabolic risk factors in non-cancer and cancer patients and provide recommendations aimed to reduce cardiovascular events, morbidity, and mortality.
2019冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的高传染性病毒性疾病。鉴于其在全球范围内惊人的传播速度，世界卫生组织已将其定义为大流行病。SARS-CoV-2与血管紧张素转换酶2和跨膜丝氨酸蛋白酶2相互作用，后者是一种丝氨酸蛋白酶，在肺、胃肠道和心肌细胞中均有表达。COVID-19患者会出现不良心脏事件（高血压、静脉血栓栓塞、心律失常、心肌损伤、暴发性心肌炎），而既往有心血管疾病的患者死亡风险更高。癌症患者极易感染病毒，且与健康人相比预后更差，其影响程度取决于癌症类型、近期的化疗、放疗或手术以及其他合并症（糖尿病、心血管疾病、代谢综合征）。与非癌症患者相比，患有活动性癌症或接受心脏毒性治疗的患者可能因SARS-CoV-2感染而使心脏损害加剧。我们从最新的前瞻性和回顾性研究角度，重点关注癌症患者的主要结局，突出COVID-19的心血管副作用。我们关注非癌症和癌症患者的主要心脏代谢危险因素，并提供旨在减少心血管事件、发病率和死亡率的建议。
