Coronavirus disease 2019 and cardiovascular complications: focused clinical review.
Coronavirus disease 2019 and cardiovascular complications: focused clinical review.
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DOI：
10.1097/hjh.0000000000002819
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发表时间：
2021-07-01
影响因子：
4.9
通讯作者：
中科院分区：
文献类型：
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冠状病毒病2019年(新冠肺炎)不仅可能导致急性呼吸窘迫综合征，还可能导致多器官损伤和衰竭，需要重症监护并导致死亡。男性、高龄、慢性肺部疾病、慢性肾脏疾病以及高血压、糖尿病和肥胖等心血管疾病已被确定为新冠肺炎严重程度的风险因素。据推测，由于这三个心血管危险因素与多器官损害的高患病率有关。在本篇重点临床综述中，我们将讨论新冠肺炎的心血管并发症，包括急性心血管综合征(急性心脏损伤/冠状病毒心肌病、血栓栓塞症并发症和心律失常)和新冠肺炎的后遗症。初步数据显示，急性心血管综合征的病因可能是多因素的，涉及病毒对心脏和血管系统的直接入侵，以及通过免疫和炎症介导的全身性细胞因子风暴。新冠肺炎幸存者在静息状态下也可能表现出持续的血压升高和窦性心动过速。此外，糖尿病控制不良、持续性肾脏损害和脑后遗症，如持续性认知和神经精神改变也经常被报道。对于住院期间出现急性心血管综合征和/或新冠肺炎康复后出现永久性/半永久性后遗症的新冠肺炎患者，应特别注意心血管保护。这些情况可能需要仔细的临床评估、治疗和密切随访，以避免短期和长期的并发症。
The coronavirus disease 2019 (COVID-19) may cause not only an acute respiratory distress syndrome (ARDS) but also multiple organ damage and failure requiring intensive care and leading to death. Male sex, advanced age, chronic lung disease, chronic kidney disease and cardiovascular disease, such as hypertension, diabetes and obesity have been identified as risk factors for the COVID-19 severity. Presumably, as these three cardiovascular risk factors are associated with a high prevalence of multiorgan damage. In the present focused clinical review, we will discuss the cardiovascular complications of COVID-19 including acute cardiovascular syndrome (acute cardiac injury/COVID cardiomyopathy, thromboembolic complications and arrhythmias) and post-COVID-19 sequelae. Preliminary data shows that the cause of acute cardiovascular syndrome may be multifactorial and involve direct viral invasion of the heart and vascular system, as well as through the immune and inflammation-mediated systemic cytokine storm. COVID-19 survivors may also show persistently elevated blood pressure and sinus tachycardia at rest. Furthermore, poor diabetic control, persistent renal damage and cerebral sequelae, such as persistent cognitive and neuropsychiatric alterations are also frequently reported. A particular attention should be paid towards cardiovascular protection in COVID-19 patients who develop acute cardiovascular syndromes during hospitalization, and/or permanent/semipermanent sequelae after recovery from COVID-19. These conditions may require careful clinical assessment, treatment and close follow-up to avoid short-term and long-term complications.