1. Cardiovascular disease and COVID-19: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)
- Author
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Maria Dorobantu, Dirk J. Duncker, Geneviève Derumeaux, Diana A. Gorog, Zorana Vasiljevic-Pokrajcic, Cor de Wit, Marija Vavlukis, Dimitris Tousoulis, Etto C. Eringa, Edina Cenko, Christian Hassager, Davor Miličić, Teresa Padró, Giuseppe De Luca, Gemma Vilahur, Marc J. Claeys, Lina Badimon, Danijela Trifunovic-Zamaklar, Raffaele Bugiardini, Frank R. Heinzel, Olivia Manfrini, Evangelos Oikonomou, Kurt Huber, RS: Carim - H08 Experimental atrial fibrillation, Fysiologie, Physiology, ACS - Diabetes & metabolism, Cenko E., Badimon L., Bugiardini R., Claeys M.J., De Luca G., de Wit C., Derumeaux G., Dorobantu M., Duncker D.J., Eringa E.C., Gorog D.A., Hassager C., Heinzel F.R., Huber K., Manfrini O., Milicic D., Oikonomou E., Padro T., Trifunovic-Zamaklar D., Vasiljevic-Pokrajcic Z., Vavlukis M., Vilahur G., and Tousoulis D.
- Subjects
Physiology ,Disease ,Review ,CORONAVIRUS ,030204 cardiovascular system & hematology ,Bioinformatics ,endothelial dysfunction ,0302 clinical medicine ,cytokine ,Cardiometabolic Risk Factor ,thrombosi ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Endothelial dysfunction ,CARDIOLOGY ,Clinical Trials as Topic ,Sex Characteristics ,post-acute COVID-19 ,THROMBOEMBOLISM FOLLOWING HOSPITALIZATION ,Inflammation/complications ,Cardiovascular disease ,Thrombosis ,Pathophysiology ,3. Good health ,Cardiovascular Diseases ,Myocardial injury ,Cardiovascular Diseases/enzymology ,COVID-19/complications ,Angiotensin-Converting Enzyme 2 ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Infection ,Viral load ,POSITION PAPER ,Human ,ANGIOTENSIN-CONVERTING ENZYME ,EXPRESSION ,SEX-DIFFERENCES ,microcirculation ,Inflammation ,Angiotensin-Converting Enzyme 2/metabolism ,03 medical and health sciences ,Post-Acute COVID-19 Syndrome ,SDG 3 - Good Health and Well-being ,Physiology (medical) ,medicine ,Humans ,thrombosis ,business.industry ,SARS-CoV-2 ,INFLAMMATORY RESPONSE ,Cardiometabolic Risk Factors ,COVID-19 ,medicine.disease ,CARDIAC ARREST SYNDROME ,cytokines ,inflammation ,Cardiovascular Injury ,Myocardial fibrosis ,Human medicine ,business - Abstract
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., Graphical Abstract Graphical Abstract
- Published
- 2021