Vinciguerra Mattia, Romiti Silvia, Sangiorgi Giuseppe Massimo, Rose David, Miraldi Fabio, Greco Ernesto
Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Division of Cardiology, Department of Biomedicine and Prevention, Cardiac Cath Lab, University of Tor Vergata, 00133 Rome, Italy.
J Cardiovasc Dev Dis. 2021 Oct 10;8(10):130. doi: 10.3390/jcdd8100130.
At the beginning of the COVID-19 pandemic, the lung was recognized as the main target organ; now, new evidence suggests that SARS-CoV-2 infection leads to vascular disease. In a previous review, we supposed a bidirectional link between endothelial dysfunction and COVID-19, identifying atherosclerosis as having a crucial role in its pathogenesis. Atherosclerosis with an existing endothelial dysfunction may worsen COVID-19 manifestations, leading to adverse outcomes, as largely reported. However, COVID-19 may be the trigger factor in the progression of the atherosclerotic process up to making it clinically manifest. The thrombotic complications can involve not only the atherosclerotic plaque, but also the durability of the surgical device implanted to treat a pre-existing coronary artery disease as recently reported. The burden of the disease makes necessary a long-term stratification of patients, revising drastically targeted therapy among others.
在新冠疫情初期，肺被认为是主要靶器官；如今，新证据表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染会导致血管疾病。在之前的一篇综述中，我们推测内皮功能障碍与新冠之间存在双向联系，认为动脉粥样硬化在其发病机制中起关键作用。如大量报道所示，已存在内皮功能障碍的动脉粥样硬化可能会使新冠症状恶化，导致不良后果。然而，新冠可能是动脉粥样硬化进程发展直至临床表现出现的触发因素。血栓形成并发症不仅可能累及动脉粥样硬化斑块，还可能影响为治疗已存在的冠状动脉疾病而植入的手术装置的耐久性，这是最近报道的情况。鉴于该疾病的负担，有必要对患者进行长期分层，同时大幅修订靶向治疗等。
