Sympathetic activation: a potential link between comorbidities and COVID-19
Sympathetic activation: a potential link between comorbidities and COVID-19
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DOI：
10.1111/febs.15481
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发表时间：
2020-08-01
期刊：
影响因子：
5.4
通讯作者：
De Caro, Raffaele
中科院分区：
文献类型：
--
作者：
Porzionato, Andrea;Emmi, Aron;De Caro, Raffaele
在冠状病毒疾病2019年(新冠肺炎)中，较高的发病率和死亡率与年龄、男性和慢性肺部疾病、心血管疾病、高血压、肾脏疾病、糖尿病和肥胖等并存疾病有关。所有上述情况的特征都是交感神经放电增加，这可能通过对肺、心脏、血管、肾脏、新陈代谢和/或免疫系统的作用，对新冠肺炎患者产生显著的有害影响。此外，新冠肺炎还可能通过改变血气(慢性间歇性低氧、高呼吸)、血管紧张素转换酶1/血管紧张素转换酶2失衡、免疫/炎症因子或情绪困扰而增加交感神经放电。然而，交感神经系统在新冠肺炎的病理生理学中的潜在作用尚未被考虑。在我们看来，交感神经过度激活可能代表了一种迄今为止被低估的机制，导致了新冠肺炎和共病之间的恶性循环。
In coronavirus disease 2019 (COVID-19), higher morbidity and mortality are associated with age, male gender, and comorbidities, such as chronic lung diseases, cardiovascular pathologies, hypertension, kidney diseases, diabetes mellitus, and obesity. All of the above conditions are characterized by increased sympathetic discharge, which may exert significant detrimental effects on COVID-19 patients, through actions on the lungs, heart, blood vessels, kidneys, metabolism, and/or immune system. Furthermore, COVID-19 may also increase sympathetic discharge, through changes in blood gases (chronic intermittent hypoxia, hyperpnea), angiotensin-converting enzyme (ACE)1/ACE2 imbalance, immune/inflammatory factors, or emotional distress. Nevertheless, the potential role of the sympathetic nervous system has not yet been considered in the pathophysiology of COVID-19. In our opinion, sympathetic overactivation could represent a so-far undervalued mechanism for a vicious circle between COVID-19 and comorbidities.