Getting to the Heart of the Matter: Myocardial Injury, Coagulopathy, and Other Potential Cardiovascular Implications of COVID-19.

IF 2.5 Q2 PERIPHERAL VASCULAR DISEASE
International Journal of Vascular Medicine Pub Date : 2021-04-22 eCollection Date: 2021-01-01 DOI:10.1155/2021/6693895
Aaron Schmid, Marija Petrovic, Kavya Akella, Anisha Pareddy, Sumathilatha Sakthi Velavan
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引用次数: 8

Abstract

COVID-19 was primarily identified as a respiratory illness, but reports of patients presenting initially with cardiovascular complaints are rapidly emerging. Many patients also develop cardiovascular complications during and after COVID-19 infection. Underlying cardiovascular disease increases the severity of COVID-19 infection; however, it is unclear if COVID-19 increases the risk of or causes cardiovascular complications in patients without preexisting cardiovascular disease. The review is aimed at informing the primary care physicians of the potential cardiovascular complications, especially in patients without underlying cardiovascular disease. A comprehensive literature review was performed on cardiac and vascular complications of COVID-19. The primary cardiac and vascular complications include myocarditis, acute coronary syndrome, myocardial injury, arrhythmia, heart failure, shock, multisystem inflammatory syndrome, venous and arterial thrombotic events, stroke, and coagulopathy. A detailed analysis of the pathogenesis revealed six possible mechanisms: direct cardiac damage, hypoxia-induced injury, inflammation, a dysfunctional endothelial response, coagulopathy, and the catecholamine stress response. Autopsy reports from studies show cardiomegaly, hypertrophy, ventricular dilation, infarction, and fibrosis. A wide range of cardiac and vascular complications should be considered when treating patients with confirmed or suspected COVID-19 infection. Elevated troponin and natriuretic peptides indicate an early cardiac involvement in COVID-19. Continuous monitoring of coagulation by measuring serum D-dimer can potentially prevent vascular complications. A long-term screening protocol to follow-up the patients in the primary care settings is needed to follow-up with the patients who recovered from COVID cardiovascular complications.

切入核心问题:COVID-19的心肌损伤、凝血功能障碍和其他潜在心血管影响。
COVID-19最初被确定为一种呼吸道疾病,但有关最初以心血管疾病为症状的患者的报告正在迅速出现。许多患者在COVID-19感染期间和之后还会出现心血管并发症。潜在心血管疾病增加了COVID-19感染的严重程度;然而,目前尚不清楚COVID-19是否会增加无心血管疾病患者的心血管并发症风险或导致心血管并发症。该综述旨在告知初级保健医生潜在的心血管并发症,特别是在没有潜在心血管疾病的患者中。我们对COVID-19的心脏和血管并发症进行了全面的文献综述。主要的心脏和血管并发症包括心肌炎、急性冠状动脉综合征、心肌损伤、心律失常、心力衰竭、休克、多系统炎症综合征、静脉和动脉血栓形成事件、中风和凝血功能障碍。对其发病机制的详细分析揭示了六种可能的机制:直接心脏损伤、缺氧引起的损伤、炎症、内皮反应功能障碍、凝血功能障碍和儿茶酚胺应激反应。尸检报告显示心脏肥大、肥厚、心室扩张、梗塞和纤维化。在治疗确诊或疑似COVID-19感染的患者时,应考虑广泛的心血管并发症。肌钙蛋白和利钠肽升高表明COVID-19患者早期心脏受累。通过测量血清d -二聚体持续监测凝血可以潜在地预防血管并发症。需要制定长期筛查方案,在初级保健机构对COVID - 19心血管并发症康复患者进行随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Vascular Medicine
International Journal of Vascular Medicine PERIPHERAL VASCULAR DISEASE-
CiteScore
3.50
自引率
0.00%
发文量
7
审稿时长
16 weeks
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