The virus responsible for coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected over 190 million people to date, causing a global pandemic. SARS-CoV-2 relies on binding of its spike glycoprotein to angiotensin-converting enzyme 2 (ACE2) for infection. In addition to fever, cough, and shortness of breath, severe cases of SARS-CoV-2 infection may result in the rapid overproduction of pro-inflammatory cytokines. This overactive immune response is known as a cytokine storm, which leads to several serious clinical manifestations such as acute respiratory distress syndrome and myocardial injury. Cardiovascular disorders such as acute coronary syndrome (ACS) and heart failure not only enhance disease progression at the onset of infection, but also arise in hospitalized patients with COVID-19. Tissue-specific differentiated cells and organoids derived from human pluripotent stem cells (hPSCs) serve as an excellent model to address how SARS-CoV-2 damages the lungs and the heart. In this review, we summarize the molecular basis of SARS-CoV-2 infection and the current clinical perspectives of the bidirectional relationship between the cardiovascular system and viral progression. Furthermore, we also address the utility of hPSCs as a dynamic model for SARS-CoV-2 research and clinical translation.

Graphical abstract

中文翻译：

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心血管系统 SARS-CoV-2 感染的人类干细胞模型

导致 2019 年冠状病毒病 (COVID-19) 的病毒，即严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2)，迄今已感染超过 1.9 亿人，造成全球大流行。SARS-CoV-2 依赖于其刺突糖蛋白与血管紧张素转换酶 2 (ACE2) 的结合来进行感染。除了发烧、咳嗽和呼吸急促外，严重的 SARS-CoV-2 感染病例还可能导致促炎细胞因子迅速过量产生。这种过度活跃的免疫反应被称为细胞因子风暴，会导致多种严重的临床表现，例如急性呼吸窘迫综合征和心肌损伤。急性冠状动脉综合征 (ACS) 和心力衰竭等心血管疾病不仅在感染开始时加速疾病进展，而且在住院的 COVID-19 患者中也会出现。源自人类多能干细胞 (hPSC) 的组织特异性分化细胞和类器官是研究 SARS-CoV-2 如何损害肺和心脏的绝佳模型。在这篇综述中，我们总结了 SARS-CoV-2 感染的分子基础以及心血管系统与病毒进展之间双向关系的当前临床观点。此外，我们还讨论了 hPSC 作为 SARS-CoV-2 研究和临床转化动态模型的效用。我们总结了 SARS-CoV-2 感染的分子基础以及心血管系统与病毒进展之间双向关系的当前临床观点。此外，我们还讨论了 hPSC 作为 SARS-CoV-2 研究和临床转化动态模型的效用。我们总结了 SARS-CoV-2 感染的分子基础以及心血管系统与病毒进展之间双向关系的当前临床观点。此外，我们还讨论了 hPSC 作为 SARS-CoV-2 研究和临床转化动态模型的效用。

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