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2019冠状病毒病中的心肌损伤及其对短期和长期预后的影响

Myocardial Injury in COVID-19 and Its Implications in Short- and Long-Term Outcomes.

作者信息

Izquierdo-Marquisá Andrea, Cubero-Gallego Hector, Aparisi Álvaro, Vaquerizo Beatriz, Ribas-Barquet Núria

机构信息

Department of Cardiology, Hospital del Mar, Barcelona, Spain.

Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.

出版信息

Front Cardiovasc Med. 2022 May 26;9:901245. doi: 10.3389/fcvm.2022.901245. eCollection 2022.

Abstract

COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still a pandemic with high mortality and morbidity rates. Clinical manifestation is widely variable, including asymptomatic or mild respiratory tract illness to severe pneumonia and death. Myocardial injury is a significant pathogenic feature of COVID-19 and it is associated with worse in-hospital outcomes, mainly due to a higher number of hospital readmissions, with over 50% mortality. These findings suggest that myocardial injury would identify COVID-19 patients with higher risk during active infection and mid-term follow-up. Potential contributors responsible for myocardial damage are myocarditis, vasculitis, acute inflammation, type 1 and type 2 myocardial infarction. However, there are few data about cardiac sequelae and its long-term consequences. Thus, the optimal screening tool for residual cardiac sequelae, clinical follow-up, and the benefits of a specific cardiovascular therapy during the convalescent phase remains unknown. This mini-review explores the different mechanisms of myocardial injury related to COVID-19 and its short and long-term implications.

摘要

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)仍然是一种具有高死亡率和发病率的大流行病。其临床表现广泛多样,包括无症状或轻度呼吸道疾病到严重肺炎及死亡。心肌损伤是COVID-19的一个重要致病特征,并且与更差的住院结局相关,主要原因是更高的再次入院率,死亡率超过50%。这些发现表明,心肌损伤可识别出在活跃感染期和中期随访期间风险较高的COVID-19患者。导致心肌损伤的潜在因素包括心肌炎、血管炎、急性炎症、1型和2型心肌梗死。然而,关于心脏后遗症及其长期后果的数据很少。因此,对于恢复期残余心脏后遗症的最佳筛查工具、临床随访以及特定心血管治疗的益处仍不明确。本综述探讨了与COVID-19相关的心肌损伤的不同机制及其短期和长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70f8/9204594/bdbaddb779cb/fcvm-09-901245-g001.jpg

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