Department of Medicine, Lehigh Valley Health Network, Allentown, PA.
Department of Cardiology, Lehigh Valley Health Network, Allentown, PA.
Curr Probl Cardiol. 2023 Aug;48(8):101186. doi: 10.1016/j.cpcardiol.2022.101186. Epub 2022 Mar 26.
The coronavirus pandemic has crippled healthcare system since its outbreak in 2020, and has led to over 2.6 million deaths worldwide. Clinical manifestations of COVID-19 range from asymptomatic carrier to severe pneumonia, to life-threatening acute respiratory distress syndrome (ARDS). The early efforts of the pandemic surrounded treating the pulmonary component of COVID-19, however, there has been robust data surrounding the cardiac complications associated with the virus. This is suspected to be from a marked inflammatory response as well as direct viral injury. Arrhythmias, acute myocardial injury, myocarditis, cardiomyopathy, thrombosis, and myocardial fibrosis are some of the observed cardiac complications. There have been high morbidity and mortality rates in those affected by cardiac conditions associated with COVID-19. Additionally, there have been documented cases of patients presenting with typical cardiac symptoms who are subsequently discovered to have COVID-19 infection. In those who test positive for COVID-19, clinical awareness of the significant cardiac components of the virus is pertinent to prevent morbidity and mortality. Unfortunately, treatment and preventative measures developed for COVID-19 have been shown to be also be associated with cardiac complications. This is a comprehensive review of the cardiac complications and manifestations of COVID-19 infection in addition to those associated with both treatment and vaccination.
自 2020 年爆发以来,冠状病毒大流行使医疗体系陷入瘫痪,并导致全球超过 260 万人死亡。COVID-19 的临床症状从无症状携带者到严重肺炎,再到危及生命的急性呼吸窘迫综合征(ARDS)不等。大流行早期的努力集中在治疗 COVID-19 的肺部成分上,但是,已经有大量数据表明与该病毒相关的心脏并发症。这可能是由于明显的炎症反应以及直接的病毒损伤。心律失常、急性心肌损伤、心肌炎、心肌病、血栓形成和心肌纤维化是观察到的一些心脏并发症。受 COVID-19 相关心脏疾病影响的患者发病率和死亡率很高。此外,有记录的病例表明,一些患者出现典型的心脏症状,随后被发现感染了 COVID-19。在 COVID-19 检测呈阳性的患者中,对病毒的重要心脏成分的临床认识对于预防发病率和死亡率至关重要。不幸的是,针对 COVID-19 开发的治疗和预防措施也与心脏并发症有关。这是对 COVID-19 感染以及与治疗和疫苗接种相关的心脏并发症和表现的综合回顾。