Myocardial Pathology in COVID-19-Associated Cardiac Injury: A Systematic Review.
Myocardial Pathology in COVID-19-Associated Cardiac Injury: A Systematic Review.
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DOI：
10.3390/diagnostics11091647
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发表时间：
2021-09-08
期刊：
影响因子：
--
通讯作者：
Fineschi V
中科院分区：
文献类型：
--
作者：
Maiese A;Frati P;Del Duca F;Santoro P;Manetti AC;La Russa R;Di Paolo M;Turillazzi E;Fineschi V
由于血管紧张素转换酶II（ACE 2）受体结合蛋白的普遍扩散，2019冠状病毒病（COVID-19）可能会影响所有器官。事实上，SARS-CoV-2病毒能够引起心脏病。这项系统性综述可以通过分析当前关于心脏受累的文献，为COVID-19的潜在后果提供新的视角。本系统性综述于2020年3月至2021年7月进行，通过在标题、摘要和关键词中组合和网格化术语“COVID-19”、“尸检”、“尸检”和“心脏”，检索了当前文献中SARS-CoV-2阳性患者的尸检结果。按照系统性综述和荟萃分析（PRISMA）指南的首选报告项目检索PubMed数据库。16篇论文符合纳入标准（病例报告和系列，原创研究，仅英文撰写）。共发现209例患者（平均年龄（四分位距（IQR）），60.17岁（IQR，54.75-70.75岁）; 122例男性（58.37%，男女比例为1：0.7%））。所有患者的SARS-CoV-2检测结果均呈阳性。死亡主要是呼吸衰竭的结果。第二个最常见的死亡原因是急性心力衰竭。很少有患者死于心肌炎。分析变量，如病理结果，免疫组化数据，和以前的临床评估。主要心脏病理表现为心脏扩张、坏死、心肌淋巴细胞浸润和冠状动脉小血管微血栓形成。免疫组织化学分析显示，炎症状态占主导地位的CD 3+和CD 8+细胞毒性淋巴细胞和CD 68+巨噬细胞的持续存在。COVID-19导致全身炎症反应和持续的血栓前状态。我们的系统性综述结果表明，SARS-CoV-2能够引起包括心脏在内的多个器官的不可逆变化;这反映在COVID-19幸存患者的心脏风险增加上。尸检分析（包括尸检、组织学和免疫组织化学检查）是更好地了解新出现的疾病（如COVID-19）引起的病理变化的不可或缺的工具。我们的研究结果可能会提供更多关于COVID-19患者心脏受累的信息。
Coronavirus disease 2019 (COVID-19) can potentially affect all organs owing to the ubiquitous diffusion of the angiotensin-converting enzyme II (ACE2) receptor-binding protein. Indeed, the SARS-CoV-2 virus is capable of causing heart disease. This systematic review can offer a new perspective on the potential consequences of COVID-19 through an analysis of the current literature on cardiac involvement. This systematic review, conducted from March 2020 to July 2021, searched the current literature for postmortem findings in patients who were positive for SARS-CoV-2 by combining and meshing the terms “COVID-19”, “postmortem”, “autopsy”, and “heart” in titles, abstracts, and keywords. The PubMed database was searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sixteen papers met the inclusion criteria (case reports and series, original research, only English-written). A total of 209 patients were found (mean age (interquartile range (IQR)), 60.17 years (IQR, 54.75–70.75 years); 122 men (58.37%, ratio of men to women of 1:0.7%)). Each patient tested positive for SARS-CoV-2. Death was mainly the result of respiratory failure. The second most common cause of death was acute heart failure. Few patients specifically died of myocarditis. Variables such as pathological findings, immunohistochemical data, and previous clinical assessments were analyzed. Main cardiac pathological findings were cardiac dilatation, necrosis, lymphocytic infiltration of the myocardium, and small coronary vessel microthrombosis. Immunohistochemical analyses revealed an inflammatory state dominated by the constant presence of CD3+ and CD8+ cytotoxic lymphocytes and CD68+ macrophages. COVID-19 leads to a systemic inflammatory response and a constant prothrombotic state. The results of our systematic review suggest that SARS-CoV-2 was able to cause irreversible changes in several organs, including the heart; this is reflected by the increased cardiac risk in patients who survive COVID-19. Postmortem analysis (including autopsy, histologic, and immunohistochemical examination) is an indispensable tool to better understand pathological changes caused by emerging diseases such as COVID-19. Our results may provide more information on the involvement of the heart in COVID-19 patients.
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影响因子：
2.3
作者：
Ganji, Ali;Farahani, Iman;Mosayebi, Ghasem
通讯作者：
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通讯作者：
Biering-Sørensen T
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DOI：
10.1016/j.bbrc.2004.09.106
发表时间：
2004-11-12
影响因子：
3.1
作者：
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通讯作者：
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影响因子：
15.1
作者：
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通讯作者：
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