Faculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Eur Rev Med Pharmacol Sci. 2022 Jun;26(12):4509-4519. doi: 10.26355/eurrev_202206_29090.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a viral outbreak that started in December 2019, eventually lead to a worldwide pandemic. COVID-19 usually presents with flu-like symptoms, such as headaches, dry cough, fever, fatigue, myalgia, shortness of breath, diarrhea and loss of smell or taste. However, it can also have major effects on the cardiovascular system. Based on the available relevant literature, we aimed to elaborate the possible mechanisms influencing cardiovascular damage, myocardial injury and thromboembolic disease process in particular.
After considering our inclusion and exclusion criteria, the systematic review included 8 studies in total.
In general, underlying cardiovascular diseases were associated with poorer clinical outcomes. This may be due to immunological dysregulation. The disease outcomes were also positively correlated with the severity of the disease, especially with myocardial injury. Thus, cardiac biomarkers, such as Troponin T, CK-MB and myoglobin could be utilized in prediction algorithms for deciphering the clinical outcome in COVID-19 patients.
Venous thromboembolisms were commonly encountered complications despite the administration of thromboprophylaxis, and they mostly presented as pulmonary embolisms, warranting the need for relevant investigations in hemodynamically unstable patients. However, more studies need to be conducted to better understand the mechanisms at play and the ensuing complications, to better treat COVID-19 patients.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2),也称为 COVID-19,是一种始于 2019 年 12 月的病毒性爆发,最终导致全球大流行。COVID-19 通常表现为类似流感的症状,如头痛、干咳、发热、疲劳、肌痛、呼吸急促、腹泻和失去嗅觉或味觉。然而,它也可能对心血管系统产生重大影响。根据现有相关文献,我们旨在详细阐述影响心血管损伤、心肌损伤和血栓栓塞疾病过程的可能机制。
在考虑了我们的纳入和排除标准后,系统评价共纳入了 8 项研究。
一般来说,基础心血管疾病与较差的临床结局相关。这可能是由于免疫失调。疾病结局也与疾病的严重程度呈正相关,尤其是与心肌损伤相关。因此,心脏生物标志物,如肌钙蛋白 T、CK-MB 和肌红蛋白,可用于预测算法,以破译 COVID-19 患者的临床结局。
尽管进行了血栓预防,但仍常发生静脉血栓栓塞并发症,主要表现为肺栓塞,需要对血流动力学不稳定的患者进行相关检查。然而,需要进行更多的研究,以更好地了解所涉及的机制和随之而来的并发症,从而更好地治疗 COVID-19 患者。