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新冠疫情爆发三年后的武汉:心脏医学的洞察与展望。

Wuhan 3 years after the outbreak of the pandemic-cardiological insights and perspectives.

机构信息

Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., 430030, Wuhan, China.

出版信息

Herz. 2023 Jun;48(3):173-179. doi: 10.1007/s00059-023-05176-4. Epub 2023 Apr 27.

Abstract

In November 2019, Wuhan, a city in Central China, became the center of an outbreak of pneumonia of unknown cause, which was later named "coronavirus disease 2019" (COVID-19). COVID-19 is caused by the novel severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection. The emergence of novel SARS-CoV‑2 strains and mutations exerted a serious global public health threat. Although various vaccines have been developed, specific anti-SARS-CoV‑2 drugs are limited. As cardiologists, we believe that because SARS-CoV‑2 can bind to the angiotensin 2 receptor on the surface of cardiomyocytes, it may also lead to cardiac injury. COVID-19-associated cardiac injury is not rare in clinical practice, and most of these cases are mild, while a few might progress to fulminant myocarditis (FM). Overactivated immune response and inflammatory storm represent the core pathogenesis of COVID-19-associated FM. Early identification and diagnosis of COVID-19-associated FM are critical for its treatment. Recently, Wuhan was hit by the Omicron variant again. We proposed managing COVID-19-associated cardiac injury according to the severity, which has had a significant effect on outcome.

摘要

2019 年 11 月,中国中部城市武汉成为不明原因肺炎疫情的中心,后来被命名为“2019 冠状病毒病”(COVID-19)。COVID-19 是由新型严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染引起的。新型 SARS-CoV-2 株和突变的出现对全球公共卫生构成了严重威胁。尽管已经开发出各种疫苗,但针对 SARS-CoV-2 的特效药物有限。作为心脏病专家,我们认为,由于 SARS-CoV-2 可以与心肌细胞表面的血管紧张素 2 受体结合,它也可能导致心脏损伤。COVID-19 相关的心脏损伤在临床实践中并不罕见,这些病例大多数为轻度,但少数可能进展为暴发性心肌炎(FM)。过度激活的免疫反应和炎症风暴是 COVID-19 相关 FM 的核心发病机制。早期识别和诊断 COVID-19 相关 FM 对其治疗至关重要。最近,武汉再次受到奥密克戎变异株的冲击。我们根据严重程度提出了管理 COVID-19 相关心脏损伤的建议,这对预后有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3857/10136403/8360338eb030/59_2023_5176_Fig1_HTML.jpg

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