COVID and Cardiovascular Disease: What We Know in 2021.
COVID and Cardiovascular Disease: What We Know in 2021.
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DOI：
10.1007/s11883-021-00935-2
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发表时间：
2021-05-13
影响因子：
5.8
通讯作者：
Michos ED
中科院分区：
文献类型：
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作者：
Chilazi M;Duffy EY;Thakkar A;Michos ED
2019年冠状病毒病(新冠肺炎)一直是导致全球重大发病率和死亡率的原因。在这里，我们回顾了迄今为止关于严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)感染对心脏的短期和长期后果的文献。早期病例报告描述了新冠肺炎的一系列心血管表现，包括心肌炎、应激性心肌病、心肌梗死和心律失常。然而，在大多数情况下，新冠肺炎的心肌损伤似乎主要是由危重疾病的严重程度介导的，而不是病毒颗粒对心肌的直接损伤。虽然心脏磁共振成像仍然是诊断急性心肌炎的有力工具，但鉴于心肌炎的基线患病率较低，应该明智地使用它。指导运动患者在新冠肺炎感染后重返赛场是一个具有挑战性的过程。最近的数据显示，RTP使用筛查方案是一种安全的尝试。“长期冠状病毒病”或SARS-CoV-2感染的急性后遗症也被描述。报告的症状涉及广泛的心肺和神经系统主诉，包括疲劳、心悸、胸痛、呼吸困难、脑雾和包括体位性心动过速综合征(POTS)在内的自主功能障碍。POTS/自主功能障碍的管理主要集中在教育、运动以及盐和液体的补充上。我们对新冠肺炎对心血管系统影响的认识在不断演变。随着我们进入一个新的生存时代，需要更多的研究来分类持续性心肺症状的负担。还需要进行研究，以了解急性管理如何改变这种慢性综合症的可能性和患病率。
Coronavirus disease 2019 (COVID-19) has been the cause of significant global morbidity and mortality. Here, we review the literature to date of the short-term and long-term consequences of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on the heart. Early case reports described a spectrum of cardiovascular manifestations of COVID-19, including myocarditis, stress cardiomyopathy, myocardial infarction, and arrhythmia. However, in most cases, myocardial injury in COVID-19 appears to be predominantly mediated by the severity of critical illness rather than direct injury to myocardium from viral particles. While cardiac magnetic resonance imaging remains a powerful tool for diagnosing acute myocarditis, it should be used judiciously in light of low baseline prevalence of myocarditis. Guiding an athletic patient through return to play (RTP) after COVID-19 infection is a challenging process. More recent data show RTP has been a safe endeavor using a screening protocol. “Long COVID” or post-acute sequelae of SARS-CoV-2 infection has also been described. The reported symptoms span a large breadth of cardiopulmonary and neurologic complaints including fatigue, palpitations, chest pain, breathlessness, brain fog, and dysautonomia including postural tachycardia syndrome (POTS). Management of POTS/dysautonomia primarily centers on education, exercise, and salt and fluid repletion. Our understanding of the impact of COVID-19 on the cardiovascular system is constantly evolving. As we enter a new age of survivorship, additional research is needed to catalogue the burden of persistent cardiopulmonary symptoms. Research is also needed to learn how acute management may alter the likelihood and prevalence of this chronic syndrome.