ABSTRACT

Introduction

Coronavirus disease 2019 (COVID-19) has the characteristics of high transmission, diverse clinical manifestations, and a long incubation period. In addition to infecting the respiratory system, COVID-19 also has adverse effects on the cardiovascular system. COVID-19 causes acute myocardial injuries, as well as chronic damage to the cardiovascular system.

Areas covered

The present review is aimed at providing current information on COVID-19 and the cardiovascular system. PubMed, Scopus, Science direct, and Google Scholar were searched.

Expert opinion

It is suggested that heart injury caused by COVID-19 infection might be an important cause of severe clinical phenotypes or adverse events in affected patients. Myocardial damage is closely related to the severity of the disease and even the prognosis in patients with COVID-19. In addition to disorders that are caused by COVID-19 on the cardiovascular system, more protection should be employed for patients with preexisting cardiovascular disease (CVD). Hence, it is very important that once relevant symptoms appear, patients with COVID-19 be rapidly treated to reduce mortality. Thus, early measurements of cardiac damage via biomarkers following hospitalization for COVID-19 infections in a patient with preexisting CVD are recommended, together with careful monitoring of any myocardial injury that might be caused by the infection.

Abbreviations: ICU: An intensive care unit; 2019-nCoV: 2019 novel coronavirus; ACEI: ACE inhibitor; ACS: Acute coronary syndrome; ARDS: Acute respiratory distress syndrome; AT₁R: Ang II type 1 receptor; ATP: Adenosine triphosphate; ACC: American College of Cardiology; ACE: Angiotensin converting enzyme; Ang II: Angiotensin II; ARB: Angiotensin II receptor blocker; AV block: Atrioventricular block; CAD: Coronary artery disease; CVD: Cardiovascular disease; CT: Computerized tomography; CHF: Congestive heart failure; CHD: Coronary heart disease; CK-MB: Creatine kinase isoenzyme-MB; CRP: C-reactive protein; cTnI: Cardiac troponin I; EAT: Epicardial adipose tissue; ECMO: Extracorporeal membrane oxygenation; FDA: Food and Drug Administration; G-CSF: Granulocyte colony-stimulating factor; HFrEF: HF with a reduced ejection fraction; synhACE2: Human isoform of ACE2; IL: Interleukin; IABP: Intra-aortic balloon counterpulsation; IP10: Interferon γ-induced protein 10 kDa; LPC: Lysophosphatidylcholine; Mas: Mitochondrial assembly receptor; MCP1: Monocyte chemoattractant protein-1; MERS: Middle East respiratory syndrome; MIP1a: macrophage inflammatory protein 1a: MOF: Multiple organ failure; MI: Myocardial infarction; MRI: Magnetic resonance imaging; MYO: Myohe-moglobin; NT-proBNP: N-terminal pro-brain natriuretic peptide; PCPS: Percutaneous cardiopulmonary assistance; rhACE2: Recombinant human ACE2; SARS: Severe acute respiratory syndrome; Th: T helper; RAS: Renin-angiotensin system; TNF-α: Tumor necrosis factor-α; WHO: World Health Organization.

中文翻译：

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COVID-19 和心脏损伤：临床表现、生物标志物、机制、诊断、治疗和随访

摘要

介绍

2019冠状病毒病（COVID-19）具有传播率高、临床表现多样、潜伏期长等特点。除了感染呼吸系统外，COVID-19 对心血管系统也有不利影响。COVID-19 会导致急性心肌损伤，以及对心血管系统的慢性损伤。

涵盖的领域

本综述旨在提供有关 COVID-19 和心血管系统的最新信息。搜索了 PubMed、Scopus、Science direct 和 Google Scholar。

专家意见

有人认为，由 COVID-19 感染引起的心脏损伤可能是受影响患者出现严重临床表型或不良事件的重要原因。心肌损伤与 COVID-19 患者疾病的严重程度甚至预后密切相关。除了 COVID-19 对心血管系统造成的疾病外，还应为已有心血管疾病 (CVD) 的患者提供更多保护。因此，一旦出现相关症状，迅速治疗 COVID-19 患者以降低死亡率非常重要。因此，通过早期测量心脏损伤建议在患有既往 CVD 的患者中住院治疗 COVID-19 感染后使用生物标志物，同时仔细监测可能由感染引起的任何心肌损伤。

缩写：ICU：重症监护病房；2019-nCoV：2019新型冠状病毒；ACEI：ACE抑制剂；ACS：急性冠状动脉综合征；ARDS：急性呼吸窘迫综合征；AT ₁ R：Ang II 1 型受体；ATP：三磷酸腺苷；ACC：美国心脏病学院；ACE：血管紧张素转换酶；Ang II：血管紧张素 II；ARB：血管紧张素 II 受体阻滞剂；房室传导阻滞：房室传导阻滞；CAD：冠状动脉疾病；化学气相沉积： 心血管疾病; CT：计算机断层扫描；CHF：充血性心力衰竭；CHD：冠心病；CK-MB：肌酸激酶同工酶-MB；CRP：C反应蛋白；cTnI：心肌肌钙蛋白 I；EAT：心外膜脂肪组织；ECMO：体外膜氧合；FDA：食品和药物管理局；G-CSF：粒细胞集落刺激因子；HFrEF：射血分数降低的 HF；synhACE2：人类 ACE2 异构体；IL：白细胞介素；腹主动脉瘤：主动脉内球囊反搏；IP10：干扰素 γ 诱导蛋白 10 kDa；LPC：溶血磷脂酰胆碱；Mas：线粒体组装受体；MCP1：单核细胞趋化蛋白-1；MERS：中东呼吸综合征；MIP1a：巨噬细胞炎症蛋白 1a：MOF：多器官衰竭；MI：心肌梗塞；MRI：磁共振成像；MYO：肌血红蛋白；NT-proBNP：N-末端前脑利钠肽；PCPS：经皮心肺辅助；rhACE2：重组人ACE2；SARS：严重急性呼吸系统综合症；Th : T 助手；RAS：肾素-血管紧张素系统；TNF-α：肿瘤坏死因子-α；世界卫生组织：世界卫生组织。