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新型冠状病毒肺炎感染后的血管改变:一项综合文献综述

Vascular Alterations Following COVID-19 Infection: A Comprehensive Literature Review.

作者信息

Karakasis Paschalis, Nasoufidou Athina, Sagris Marios, Fragakis Nikolaos, Tsioufis Konstantinos

机构信息

Second Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece.

First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece.

出版信息

Life (Basel). 2024 Apr 24;14(5):545. doi: 10.3390/life14050545.

Abstract

SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It affects both microvasculature and macrovasculature, leading to thromboembolic events, cardiovascular manifestations, impaired arterial stiffness, cerebrovascular complications, and nephropathy, as well as retinopathy-frequently observed in cases of severe illness. Evidence suggests that SARS-CoV-2 infection may result in persistent effects on the vascular system, identified as long-term COVID-19. This is characterized by prolonged inflammation, endotheliopathy, and an increased risk of vascular complications. Various imaging modalities, histopathological studies, and diagnostic tools such as video capillaroscopy and magnetic resonance imaging have been employed to visualize vascular alterations. This review aims to comprehensively summarize the evidence concerning short and long-term vascular alterations following COVID-19 infection, investigating their impact on patients' prognosis, and providing an overview of preventive strategies to mitigate associated vascular complications.

摘要

正在肆虐的新冠疫情的病原体严重急性呼吸综合征冠状病毒2(SARS-CoV-2)已显示出超出呼吸系统的更广泛影响,主要影响血管系统并伴有各种不良表现。该感染会引发内皮功能障碍和免疫系统失调,从而形成炎症和高凝状态。它会影响微血管和大血管,导致血栓栓塞事件、心血管表现、动脉僵硬度受损、脑血管并发症、肾病以及视网膜病变(在重症病例中经常观察到)。有证据表明,SARS-CoV-2感染可能会对血管系统产生持续影响,即所谓的长期新冠。其特征是炎症持续、内皮病变以及血管并发症风险增加。已采用各种成像方式、组织病理学研究以及诸如视频毛细血管镜检查和磁共振成像等诊断工具来观察血管改变。本综述旨在全面总结有关新冠病毒感染后短期和长期血管改变的证据,研究它们对患者预后的影响,并概述减轻相关血管并发症的预防策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a1d/11122535/a8e1a6c062dd/life-14-00545-g001.jpg

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