Yang Yaliu, Yan Mengwen
Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
Front Cardiovasc Med. 2022 May 4;9:859505. doi: 10.3389/fcvm.2022.859505. eCollection 2022.
The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), represents a great threat to healthcare and socioeconomics worldwide. In addition to respiratory manifestations, COVID-19 promotes cardiac injuries, particularly in elderly patients with cardiovascular history, leading to a higher risk of progression to critical conditions. The SARS-CoV-2 infection is initiated as virus binding to angiotensin-converting enzyme 2 (ACE2), which is highly expressed in the heart, resulting in direct infection and dysregulation of the renin-angiotensin system (RAS). Meanwhile, immune response and hyper-inflammation, as well as endothelial dysfunction and thrombosis implicate in COVID-19 infection. Herein, we provide an overview of the proposed mechanisms of cardiovascular injuries in COVID-19, particularly in elderly patients with pre-existing cardiovascular diseases, aiming to set appropriate management and improve their clinical outcomes.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）大流行对全球医疗保健和社会经济构成了巨大威胁。除了呼吸道表现外，COVID-19还会引发心脏损伤，尤其是在有心血管病史的老年患者中，导致病情进展至危急状态的风险更高。SARS-CoV-2感染始于病毒与血管紧张素转换酶2（ACE2）结合，ACE2在心脏中高度表达，导致直接感染和肾素-血管紧张素系统（RAS）失调。同时，免疫反应和过度炎症，以及内皮功能障碍和血栓形成也与COVID-19感染有关。在此，我们概述了COVID-19中心血管损伤的潜在机制，特别是在已有心血管疾病的老年患者中，旨在制定适当的管理措施并改善其临床结局。
