严重急性呼吸综合征冠状病毒2（SARS-CoV-2）损害心肌细胞线粒体，并与长期新冠病毒感染相关的心血管表现有关。

SARS-CoV-2 damages cardiomyocyte mitochondria and implicates long COVID-associated cardiovascular manifestations.

作者信息

Che Wenliang, Guo Shuai, Wang Yanqun, Wan Xiaohua, Tan Bingyu, Li Hailing, Alifu Jiasuer, Zhu Mengyun, Chen Zesong, Li Peiyao, Zhang Lei, Zhang Zhaoyong, Wang Yiliang, Huang Xiaohan, Wang Xinsheng, Zhu Jian, Pan Xijiang, Zhang Fa, Wang Peiyi, Sui Sen-Fang, Zhao Jincun, Xu Yawei, Liu Zheng

机构信息

Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Cryo-electron Microscopy Center, Southern University of Science and Technology, Shenzhen, China; School of Life Science, Southern University of Science and Technology, Shenzhen, China.

出版信息

J Adv Res. 2025 May 10. doi: 10.1016/j.jare.2025.05.013.

DOI:10.1016/j.jare.2025.05.013

PMID:40354933

Abstract

INTRODUCTION

With the COVID-19 pandemic becoming endemic, vigilance for Long COVID-related cardiovascular issues remains essential, though their specific pathophysiology is largely unexplored.

OBJECTIVES

Our study investigates the persistent cardiovascular symptoms observed in individuals long after contracting SARS-CoV-2, a condition commonly referred to as "Long COVID", which has significantly affected millions globally.

METHODS

We meticulously describe the cardiovascular outcomes in five patients, encompassing a range of severe conditions such as sudden cardiac death during exercise, coronary atherosclerotic heart disease, palpitation, chest tightness, and acute myocarditis.

RESULTS

All five patients were diagnosed with myocarditis, confirmed through endomyocardial biopsy and histochemical staining, which identified inflammatory cell infiltration in their heart tissue. Crucially, electron microscopy revealed widespread mitochondrial vacuolations and the presence of myofilament degradation within the cardiomyocytes of these patients. These findings were mirrored in SARS-CoV-2-infected mice, suggesting a potential underlying cellular mechanism for the cardiac effects associated with Long COVID.

CONCLUSION

Our findings demonstrate a profound impact of SARS-CoV-2 on mitochondrial integrity, shedding light on the cardiovascular implications of Long COVID.

摘要

引言

随着新冠疫情成为地方性流行病，对与新冠长期症状相关的心血管问题保持警惕仍然至关重要，尽管其具体病理生理学在很大程度上尚未得到探索。

目的

我们的研究调查了感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）很长时间后个体中观察到的持续性心血管症状，这种情况通常被称为“新冠长期症状”，已在全球范围内显著影响了数百万人。

方法

我们详细描述了五名患者的心血管结局，包括一系列严重病症，如运动时心源性猝死、冠状动脉粥样硬化性心脏病、心悸、胸闷和急性心肌炎。

结果

所有五名患者均被诊断为心肌炎，通过心内膜心肌活检和组织化学染色得以证实，该检查确定了他们心脏组织中的炎性细胞浸润。至关重要的是，电子显微镜显示这些患者的心肌细胞内存在广泛的线粒体空泡化以及肌丝降解。这些发现在感染SARS-CoV-2的小鼠中也得到了印证，表明与新冠长期症状相关的心脏效应可能存在潜在的细胞机制。