Department of Medicine, Faculty of Medicine, Imperial College London, London SW7 2AD, UK.
King's College London BHF Centre, The Rayne Institute, St Thomas' Hospital, London SE1 7EH, UK.
Viruses. 2022 Jun 17;14(6):1322. doi: 10.3390/v14061322.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in over 6 million deaths and significant morbidity across the globe. Alongside common respiratory symptoms, COVID-19 is associated with a variety of cardiovascular complications in the acute and post-acute phases of infection. The suggested pathophysiological mechanisms that underlie these complications include direct viral infection of the myocardium via the angiotensin-converting enzyme 2 (ACE2) protein and a cytokine release syndrome that results in indirect inflammatory damage to the heart. Patients with pre-existing cardiovascular disease and co-morbidities are generally more susceptible to the cardiac manifestations of COVID-19. However, studies have identified a variety of complications in low-risk individuals, including young adults and children. Myocarditis and paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS) are among the adverse events reported in the acute phase of infection. Furthermore, patients have reported cardiac symptoms persisting beyond the acute phase in post-COVID syndrome. This review summarises the acute and chronic cardiac consequences of COVID-19 in low-risk patients, explores the pathophysiology behind them, and discusses new predictive factors for poor outcomes.
2019 年冠状病毒病(COVID-19)大流行导致全球超过 600 万人死亡和大量发病。除了常见的呼吸道症状外,COVID-19 在感染的急性期和恢复期还与多种心血管并发症相关。这些并发症的潜在病理生理机制包括病毒通过血管紧张素转换酶 2(ACE2)蛋白直接感染心肌,以及导致心肌间接炎症损伤的细胞因子释放综合征。患有心血管疾病和合并症的患者通常更容易出现 COVID-19 的心脏表现。然而,研究已经在低危人群中发现了多种并发症,包括年轻人和儿童。心肌炎和与 COVID-19 相关的儿童炎症多系统综合征(PIMS)是感染急性期报告的不良事件之一。此外,患者报告在 COVID 后综合征中,心脏症状持续存在于急性期之后。本综述总结了低危患者 COVID-19 的急性和慢性心脏后果,探讨了其背后的病理生理学,并讨论了不良预后的新预测因素。