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Ionescu M, Stoian AP, Rizzo M, Serban D, Nuzzo D, Mazilu L, Suceveanu AI, Dascalu AM, Parepa IR. The Role of Endothelium in COVID-19. Int J Mol Sci 2021; 22:11920. [PMID: 34769350 DOI: 10.3390/ijms222111920] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 01/08/2023] Open
Abstract
The 2019 novel coronavirus, known as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19), is causing a global pandemic. The virus primarily affects the upper and lower respiratory tracts and raises the risk of a variety of non-pulmonary consequences, the most severe and possibly fatal of which are cardiovascular problems. Data show that almost one-third of the patients with a moderate or severe form of COVID-19 had preexisting cardiovascular comorbidities such as diabetes mellitus, obesity, hypertension, heart failure, or coronary artery disease. SARS-CoV2 causes hyper inflammation, hypoxia, apoptosis, and a renin–angiotensin system imbalance in a variety of cell types, primarily endothelial cells. Profound endothelial dysfunction associated with COVID-19 can be the cause of impaired organ perfusion that may generate acute myocardial injury, renal failure, and a procoagulant state resulting in thromboembolic events. We discuss the most recent results on the involvement of endothelial dysfunction in the pathogenesis of COVID-19 in patients with cardiometabolic diseases in this review. We also provide insights on treatments that may reduce the severity of this viral infection.
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Sun H, Su X, Huang L, Mu D, Qu Y. Research Progress on the Cardiac Injury from ACE2 Targeting in SARS-CoV-2 Infection. Biomolecules 2021; 11:196. [PMID: 33573324 PMCID: PMC7911115 DOI: 10.3390/biom11020196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/23/2021] [Accepted: 01/27/2021] [Indexed: 01/08/2023] Open
Abstract
The epidemic due to the novel coronavirus (SARS-CoV-2) is now a global concern, posing a severe threat to the health of populations. At present, all countries in the world are stepping up the development of vaccines and antiviral agents to prevent the infection and further transmission of SARS-CoV-2. An in-depth investigation of the target organs and pathogenesis regarding SARS-CoV-2 infection will be beneficial for virus therapy. Besides pulmonary injury, SARS-CoV-2 also causes cardiac injury, but the exact mechanisms are unclear. This review summarizes the essential structural characteristics of SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2), describes the cardiac manifestations following SARS-CoV-2 infection, and explores the mechanisms of cardiac injury targeting ACE2 after the viral invasion. We aim to help the timely detection of related symptoms and implementation of therapeutic measures by clinicians for SARS-CoV-2 infection.
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Affiliation(s)
- Hao Sun
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Xiaojuan Su
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Lingyi Huang
- West China College of Stomatology, Sichuan University, Chengdu 610041, China;
| | - Dezhi Mu
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Yi Qu
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
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Cameli M, Pastore MC, Soliman Aboumarie H, Mandoli GE, D'Ascenzi F, Cameli P, Bigio E, Franchi F, Mondillo S, Valente S. Usefulness of echocardiography to detect cardiac involvement in COVID-19 patients. Echocardiography 2020; 37:1278-1286. [PMID: 32654210 PMCID: PMC7404652 DOI: 10.1111/echo.14779] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID‐19) outbreak is a current global healthcare burden, leading to the life‐threatening severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). However, evidence showed that, even if the prevalence of COVID‐19 damage consists in pulmonary lesions and symptoms, it could also affect other organs, such as heart, liver, and spleen. Particularly, some infected patients refer to the emergency department for cardiovascular symptoms, and around 10% of COVID‐19 victims had finally developed heart injury. Therefore, the use of echocardiography, according to the safety local protocols and ensuring the use of personal protective equipment, could be useful firstly to discriminate between primary cardiac disease or COVID‐19–related myocardial damage, and then for assessing and monitoring COVID‐19 cardiovascular complications: acute myocarditis and arrhythmias, acute heart failure, sepsis‐induced myocardial impairment, and right ventricular failure derived from treatment with high‐pressure mechanical ventilation. The present review aims to enlighten the applications of transthoracic echocardiography for the diagnostic and therapeutic management of myocardial damage in COVID‐19 patients.
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Affiliation(s)
- Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | | | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Paolo Cameli
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Elisa Bigio
- Anesthesiology Unit, Alta Val D'Elsa Hospital, Siena, Italy
| | - Federico Franchi
- Department of Medical Biotechnologies, Anesthesia and Intensive Care, University of Siena, Siena, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Serafina Valente
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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Russo V, Bottino R, Carbone A, Rago A, Papa AA, Golino P, Nigro G. COVID-19 and Heart: From Clinical Features to Pharmacological Implications. J Clin Med 2020; 9:E1944. [PMID: 32580344 PMCID: PMC7355803 DOI: 10.3390/jcm9061944] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/06/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
A highly pathogenic human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been recently recognized in Wuhan, China, as the cause of the coronavirus disease 2019 (COVID-19) outbreak which has spread rapidly from China to other countries in the world, causing a pandemic with alarming morbidity and mortality. The emerging epidemiological data about COVID-19 patients suggest an association between cardiovascular diseases (CVD) and SARS-CoV-2 infection, in term of clinical features at hospital admission and prognosis for disease severity. The aim of our review is to describe the cardiological features of COVID-19 patients at admission, the acute cardiac presentation, the clinical outcome for patients with underlying CVD and the pharmacological implications for disease management.
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Affiliation(s)
- Vincenzo Russo
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (R.B.); (A.C.); (A.R.); (A.A.P.); (P.G.); (G.N.)
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Abstract
Coronavirus disease 2019 is a pandemic influencing the first half of the year 2020. The virus has rapidly spread to many countries. Studies are rapidly published to share information regarding epidemiology, clinical and diagnostic patterns, and prognosis. The following review condenses the surge of information into an organized format.
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Affiliation(s)
- Juan A Siordia
- Banner-University Medical Center - South Campus, Department of Medicine, 2800 E. Ajo Way, Tucson, AZ, 85713, United States.
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Chen L, Upadhya G, Guo US, Belligund P, Lee DK, Shalom I, Dubey GR, Al-Ajam MR, Mitre CA. Novel Coronavirus-Induced Right Ventricular Failure and Point of Care Echocardiography: A Case Report. Cardiology 2020; 145:467-472. [PMID: 32450565 PMCID: PMC7316647 DOI: 10.1159/000508527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 01/19/2023]
Abstract
Various cardiovascular complications have been reported in patients with coronavirus disease 2019. Common complications include acute myocardial injury, myocarditis, arrhythmia, pericarditis, heart failure, and shock. We present a case of cor pulmonale diagnosed with serial point of care ultrasound. Given the current shortage of personal protective equipment (PPE) and high infectivity of this virus, we acknowledge the utility of this tool in obtaining important clinical information while minimizing exposure and PPE consumption.
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Affiliation(s)
- Lu Chen
- Department of Internal Medicine, Downstate Medical Center, State University of New York, Brooklyn, New York, USA
- Division of Cardiology, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Gautham Upadhya
- Division of Cardiology, Department of Internal Medicine, Downstate Medical Center, State University of New York, Brooklyn, New York, USA
| | - Uta S Guo
- Sunrise Health Consortium, Southern Hills Hospital Family Medicine GME, Las Vegas, Nevada, USA
| | - Pooja Belligund
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - David K Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Isaac Shalom
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Gangacharan R Dubey
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Mohammad R Al-Ajam
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Cristina A Mitre
- Division of Cardiology, Department of Internal Medicine, Brooklyn Campus, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA,
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