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新型冠状病毒肺炎相关心血管疾病——风险、预防与管理:因新型冠状病毒肺炎而面临风险的心脏

COVID-19 Associated Cardiovascular Disease-Risks, Prevention and Management: Heart at Risk Due to COVID-19.

作者信息

Kemerley Andrew, Gupta Abhishek, Thirunavukkarasu Mahesh, Maloney Monica, Burgwardt Sean, Maulik Nilanjana

机构信息

Department of Surgery, Molecular Cardiology and Angiogenesis Laboratory, University of Connecticut School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA.

出版信息

Curr Issues Mol Biol. 2024 Feb 29;46(3):1904-1920. doi: 10.3390/cimb46030124.

Abstract

The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) virus and the resulting COVID-19 pandemic have had devastating and lasting impact on the global population. Although the main target of the disease is the respiratory tract, clinical outcomes, and research have also shown significant effects of infection on other organ systems. Of interest in this review is the effect of the virus on the cardiovascular system. Complications, including hyperinflammatory syndrome, myocarditis, and cardiac failure, have been documented in the context of COVID-19 infection. These complications ultimately contribute to worse patient outcomes, especially in patients with pre-existing conditions such as hypertension, diabetes, or cardiovascular disease (CVD). Importantly and interestingly, reports have demonstrated that COVID-19 also causes myocardial injury in adults without pre-existing conditions and contributes to systemic complications in pediatric populations, such as the development of multisystem inflammatory syndrome in children (MIS-C). Although there is still a debate over the exact mechanisms by which such complications arise, understanding the potential paths by which the virus can influence the cardiovascular system to create an inflammatory environment may clarify how SARS-CoV-2 interacts with human physiology. In addition to describing the mechanisms of disease propagation and patient presentation, this review discusses the diagnostic findings and treatment strategies and the evolution of management for patients presenting with cardiovascular complications, focusing on disease treatment and prevention.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)及其引发的新冠疫情对全球人口产生了毁灭性且持久的影响。尽管该疾病的主要靶器官是呼吸道,但临床结果及研究也表明感染对其他器官系统有显著影响。本综述关注的是该病毒对心血管系统的影响。新冠病毒感染相关的并发症,包括高炎症综合征、心肌炎和心力衰竭,已有文献记载。这些并发症最终会导致患者预后更差,尤其是对于患有高血压、糖尿病或心血管疾病(CVD)等基础疾病的患者。重要且有趣的是,有报告表明新冠病毒也会导致无基础疾病的成年人发生心肌损伤,并引发儿科人群的全身性并发症,如儿童多系统炎症综合征(MIS-C)。尽管对于此类并发症的确切发生机制仍存在争议,但了解病毒影响心血管系统以形成炎症环境的潜在途径,可能会阐明SARS-CoV-2与人体生理的相互作用方式。除了描述疾病传播机制和患者表现外,本综述还讨论了心血管并发症患者的诊断结果、治疗策略以及管理方法的演变,重点关注疾病的治疗和预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87ac/10969474/029dd1ea63b4/cimb-46-00124-g001.jpg

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