TY - JOUR
T1 - Cardiovascular disease and COVID-19
T2 - a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA)
AU - Cenko, Edina
AU - Badimon, Lina
AU - Bugiardini, Raffaele
AU - Claeys, Marc J.
AU - De Luca, Giuseppe
AU - de Wit, Cor
AU - Derumeaux, Geneviève
AU - Dorobantu, Maria
AU - Duncker, Dirk J.
AU - Eringa, Etto C.
AU - Gorog, Diana A.
AU - Hassager, Christian
AU - Heinzel, Frank R.
AU - Huber, Kurt
AU - Manfrini, Olivia
AU - Milicic, Davor
AU - Oikonomou, Evangelos
AU - Padro, Teresa
AU - Trifunovic-Zamaklar, Danijela
AU - Vasiljevic-Pokrajcic, Zorana
AU - Vavlukis, Marija
AU - Vilahur, Gemma
AU - Tousoulis, Dimitris
N1 - Publisher Copyright:
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected].
PY - 2021/12
Y1 - 2021/12
N2 - The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance.
AB - The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance.
UR - http://www.scopus.com/inward/record.url?scp=85117020753&partnerID=8YFLogxK
U2 - 10.1093/cvr/cvab298
DO - 10.1093/cvr/cvab298
M3 - Review article
C2 - 34528075
AN - SCOPUS:85117020753
SN - 0008-6363
VL - 117
SP - 2705
EP - 2729
JO - Cardiovascular Research
JF - Cardiovascular Research
IS - 14
ER -