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新型冠状病毒肺炎的急性心血管并发症:一项系统综述

Acute Cardiovascular Complications of COVID-19: A Systematic Review.

作者信息

Tolu-Akinnawo Oluwaremilekun, Adusei Poku Frank, Elimihele Thomas, League Matthew, Adkins Caleb F, Okafor Henry

机构信息

Internal Medicine, Meharry Medical College, Nashville, USA.

Medicine, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Knoxville, USA.

出版信息

Cureus. 2023 May 5;15(5):e38576. doi: 10.7759/cureus.38576. eCollection 2023 May.

Abstract

Since the pandemic in 2019, coronavirus 2019 (COVID-19) has continued to be linked with a variety of organ systems and complications. While it is generally considered a respiratory disease, its link with the heart is widely discussed in the literature. This article focuses on the acute cardiovascular complications of COVID-19 and the possible predictors of these complications. Our study included 97 articles (58 case reports, eight case series, 23 retrospective cohort studies, five prospective cohort studies, and three cross-sectional studies). Several mechanisms have been proposed to explain COVID-19-induced cardiovascular complications, with cytokine-induced inflammation and direct cardiac damage noted as the significant focus. Patients with underlying cardiovascular complications such as hypertension and diabetes were noted to be at increased risk of acute cardiovascular complications, as well as an increased risk of severe disease and death. Also, acute myocardial infarction and arrhythmias were two of the most common acute cardiovascular complications noted in our review. Other acute cardiovascular complications are myocarditis, takotsubo syndrome, acute thromboembolic events, and pericardial complications. This article provides an updated review of acute cardiovascular complications of COVID-19, its pathogenesis, and risk stratification and emphasizes the need for high suspicion in patients with underlying cardiovascular risk factors.

摘要

自2019年疫情以来,2019冠状病毒病(COVID-19)持续与多种器官系统及并发症相关联。虽然它通常被视为一种呼吸道疾病,但其与心脏的关联在文献中得到了广泛讨论。本文聚焦于COVID-19的急性心血管并发症以及这些并发症的可能预测因素。我们的研究纳入了97篇文章(58篇病例报告、8篇病例系列、23篇回顾性队列研究、5篇前瞻性队列研究和3篇横断面研究)。已经提出了几种机制来解释COVID-19引发的心血管并发症,其中细胞因子诱导的炎症和直接心脏损伤成为重要关注点。有潜在心血管并发症(如高血压和糖尿病)的患者被指出急性心血管并发症风险增加,以及重症和死亡风险增加。此外,急性心肌梗死和心律失常是我们综述中最常见的两种急性心血管并发症。其他急性心血管并发症包括心肌炎、应激性心肌病、急性血栓栓塞事件和心包并发症。本文提供了关于COVID-19急性心血管并发症、其发病机制和风险分层的最新综述,并强调对有潜在心血管危险因素的患者需高度怀疑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c60a/10166388/9f5e6e13a724/cureus-0015-00000038576-i01.jpg

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