Pandemic Perspective: Commonalities Between COVID-19 and Cardio-Oncology.
Pandemic Perspective: Commonalities Between COVID-19 and Cardio-Oncology.
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大流行视角：COVID-19与心脏肿瘤学之间的共同点。
DOI：
10.3389/fcvm.2020.568720
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发表时间：
2020
影响因子：
3.6
通讯作者：
Widlansky M
中科院分区：
文献类型：
--
作者：
Brown SA;Zaharova S;Mason P;Thompson J;Thapa B;Ishizawar D;Wilkes E;Ahmed G;Rubenstein J;Sanchez J;Joyce D;Kalyanaraman B;Widlansky M
2019冠状病毒病（COVID-19）与心血管肿瘤学在心血管毒性（CVT）、病理生理学和药理学方面的重叠共性是大流行期间出现的特殊话题。从这个角度来看，我们考虑了COVID-19和心脏肿瘤学常见的一系列CVT，包括心肌病、缺血、传导异常、心包炎和右心室（RV）衰竭。我们还强调，患有心血管疾病（CVD）或其危险因素或癌症的患者患COVID-19严重疾病的风险更高。我们探讨了在COVID-19和心脏肿瘤学中观察到的潜在病理生理的共同点，包括炎症、细胞因子释放、肾素-血管紧张素-醛固酮系统、凝血功能障碍、微血栓形成和内皮功能障碍。此外，我们研究了已阐明的针对COVID-19 CVT和各种癌症治疗的常见药物管理策略。使用皮质类固醇，以及抗体和抑制剂的各种分子介导炎症和细胞因子释放综合征，进行了讨论。还讨论了血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）的影响，因为这些药物用于心脏肿瘤学，并且在COVID-19大流行期间受到了相当大的关注，因为罪魁祸首病毒通过血管紧张素转换酶2 （ACE2）受体进入人体细胞。因此，在COVID-19和心脏肿瘤综合征的毒性、病理生理和药理学特征方面，存在几个重叠、相似和相互作用的领域。对其中任何一个了解得更多，可能会对两者都有一定程度的了解。我们以这种观点讨论这些主题，以及我们预见的在大流行期间和以后心脏肿瘤学发展的未来方向。最后，我们强调COVID-19和心脏肿瘤学健康差异的共性，并鼓励继续开发和实施创新解决方案，以改善健康和康复方面的公平性。
Overlapping commonalities between coronavirus disease of 2019 (COVID-19) and cardio-oncology regarding cardiovascular toxicities (CVT), pathophysiology, and pharmacology are special topics emerging during the pandemic. In this perspective, we consider an array of CVT common to both COVID-19 and cardio-oncology, including cardiomyopathy, ischemia, conduction abnormalities, myopericarditis, and right ventricular (RV) failure. We also emphasize the higher risk of severe COVID-19 illness in patients with cardiovascular disease (CVD) or its risk factors or cancer. We explore commonalities in the underlying pathophysiology observed in COVID-19 and cardio-oncology, including inflammation, cytokine release, the renin-angiotensin-aldosterone-system, coagulopathy, microthrombosis, and endothelial dysfunction. In addition, we examine common pharmacologic management strategies that have been elucidated for CVT from COVID-19 and various cancer therapies. The use of corticosteroids, as well as antibodies and inhibitors of various molecules mediating inflammation and cytokine release syndrome, are discussed. The impact of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is also addressed, since these drugs are used in cardio-oncology and have received considerable attention during the COVID-19 pandemic, since the culprit virus enters human cells via the angiotensin converting enzyme 2 (ACE2) receptor. There are therefore several areas of overlap, similarity, and interaction in the toxicity, pathophysiology, and pharmacology profiles in COVID-19 and cardio-oncology syndromes. Learning more about either will likely provide some level of insight into both. We discuss each of these topics in this viewpoint, as well as what we foresee as evolving future directions to consider in cardio-oncology during the pandemic and beyond. Finally, we highlight commonalities in health disparities in COVID-19 and cardio-oncology and encourage continued development and implementation of innovative solutions to improve equity in health and healing.