COVID-lateral damage: cardiovascular manifestations of SARS-CoV-2 infection.
COVID-lateral damage: cardiovascular manifestations of SARS-CoV-2 infection.
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DOI：
10.1016/j.trsl.2021.11.005
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Zidar DA
中科院分区：
文献类型：
--
作者：
Al-Kindi S;Zidar DA
在疫情初期，对新冠病毒（COVID - 19）会伴有心血管影响的担忧，是由第一次严重急性呼吸综合征（SARS）疫情的经验、已知新冠病毒（SARS - COV2）的入侵受体（血管紧张素转换酶2，ACE2）在心脏中高度表达、心肌炎的早期报告以及治疗重症新冠患者的医生的第一手描述所引发的。在18个多月的时间里，我们对心血管表现的认识有了很大的扩展，但留下的新问题比已确凿解答的问题更多。心脏受累很常见（约20%），但在需要住院治疗的患者中并非普遍存在。心脏磁共振成像（MRI）研究提出了在症状极轻微的患者中出现相关表现的可能性。一些人似乎经历了持久的心血管症状，这是新冠病毒感染后急性后遗症这一更大综合征的一部分。疫苗诱导的血栓形成和心肌炎的病例极其罕见，但说明了监测诱发炎症的干预措施的心血管安全性的必要性。在此，我们将总结目前对新冠病毒（SARS - COV2）潜在心血管表现的认识。为了提供恰当的背景，还将讨论由其他炎症过程导致心血管损伤的范例。正在进行的研究以及对新冠病毒（COVID - 19）更深入的了解可能最终揭示心血管疾病机制基础的新见解。因此，在全球健康面临前所未有的痛苦和风险的这个时期，存在这样的机会：对新冠病毒（SARS - COV2）进行良好的转化研究可能会带来超越当前疫情的健康益处。
Early in the pandemic, concern that cardiovascular effects would accompany COVID-19 was fueled by lessons from the first SARS epidemic, knowledge that the SARS-COV2 entry receptor (Angiotensin-converting enzyme 2, ACE2) is highly expressed in the heart, early reports of myocarditis, and first-hand accounts by physicians caring for those with severe COVID-19. Over 18 months, our understanding of the cardiovascular manifestations has expanded greatly, leaving more new questions than those conclusively answered. Cardiac involvement is common (∼20%) but not uniformly observed in those who require treatment in a hospitalized setting. Cardiac MRI studies raise the possibility of manifestations in those with minimal symptoms. Some appear to experience protracted cardiovascular symptoms as part of a larger syndrome of post-acute sequelae of COVID-19. Instances of vaccine induced thrombosis and myocarditis are exceedingly rare but illustrate the need to monitor the cardiovascular safety of interventions that induce inflammation. Here, we will summarize the current understanding of potential cardiovascular manifestations of SARS-COV2. To provide proper context, paradigms of cardiovascular injury due to other inflammatory processes will also be discussed. Ongoing research and a deeper understanding COVID-19 may ultimately reveal new insight into the mechanistic underpinnings of cardiovascular disease. Thus, in this time of unprecedented suffering and risk to global health, there exists the opportunity that well conducted translational research of SARS-COV2 may provide health dividends that outlast the current pandemic.
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