Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy.
Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy.
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DOI：
10.14797/mdcvj.1044
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发表时间：
2021
影响因子：
--
通讯作者：
Jain A
中科院分区：
文献类型：
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作者：
Cooke JP;Connor JH;Jain A
SARS-CoV-2是导致冠状病毒病19（COVID-19）的病毒，与一系列令人困惑的心血管表现有关，包括心肌梗死和中风、心肌炎和心力衰竭、房性和室性心律失常、静脉血栓栓塞和微血管疾病。越来越多的证据表明，内皮稳态的严重紊乱有助于这些条件。此外，COVID-19患者的肺浸润和水肿以及随后的肺纤维化是由内皮改变促进的，包括内皮粘附分子和趋化因子的表达、细胞间渗透性增加以及内皮向间充质的转变。在这种疾病中发生的认知障碍也可能部分是由于血脑屏障受损。静脉血栓形成和肺血栓栓塞最可能与循环炎性细胞因子引起的内皮缺陷和/或病毒直接侵入内皮有关。内皮靶向治疗，如他汀类药物、一氧化氮供体和抗氧化剂，通过恢复内皮稳态，可能是COVID-19的有效治疗药物。
SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), is associated with a bewildering array of cardiovascular manifestations, including myocardial infarction and stroke, myocarditis and heart failure, atrial and ventricular arrhythmias, venous thromboembolism, and microvascular disease. Accumulating evidence indicates that a profound disturbance of endothelial homeostasis contributes to these conditions. Furthermore, the pulmonary infiltration and edema, and later pulmonary fibrosis, in patients with COVID-19 is promoted by endothelial alterations including the expression of endothelial adhesion molecules and chemokines, increased intercellular permeability, and endothelial-to-mesenchyme transitions. The cognitive disturbance occurring in this disease may also be due in part to an impairment of the blood-brain barrier. Venous thrombosis and pulmonary thromboembolism are most likely associated with an endothelial defect caused by circulating inflammatory cytokines and/or direct endothelial invasion by the virus. Endothelial-targeted therapies such as statins, nitric oxide donors, and antioxidants may be useful therapeutic adjuncts in COVID-19 by restoring endothelial homeostasis.