The Cardiovascular Manifestations of COVID-19

Louis, David; Saad, Marwan; Vijayakumar, Shilpa; Ilyas, Suleman; Kokkirala, Aravind; Aronow, Herbert D.

doi:10.1016/j.ccl.2022.03.001

Cited by 12 publications

(5 citation statements)

References 75 publications

(95 reference statements)

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“…While it is apparent that there is still no clear consensus, alternate explanations for acute myocardial injury resulting in myocardial dysfunction as identified on imaging studies, with associated poor outcomes, include injury at the level of the endothelial cell with subsequent microvascular and macrovascular thrombosis, stress cardiomyopathy, and toxic effects of angiotensin II. 62,109,124–130…”

Section: Heart Failure and Myocarditismentioning

confidence: 99%

“…122,123 While it is apparent that there is still no clear consensus, alternate explanations for acute myocardial injury resulting in myocardial dysfunction as identified on imaging studies, with associated poor outcomes, include injury at the level of the endothelial cell with subsequent microvascular and macrovascular thrombosis, stress cardiomyopathy, and toxic effects of angiotensin II. 62,109,[124][125][126][127][128][129][130] Albeit not an effect of COVID-19 and its pursuant syndrome, and therefore not discussed in this review, the discussion of myocarditis as related to COVID-19 vaccination is important and will be reviewed in detail separately within other articles included in this compendium.…”

Section: Heart Failure and Myocarditismentioning

confidence: 99%

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Interaction of COVID-19 With Common Cardiovascular Disorders

Boulos

Freeman

Henry

et al. 2023

Circulation Research

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The onset and widespread dissemination of the severe acute respiratory syndrome coronavirus-2 in late 2019 impacted the world in a way not seen since the 1918 H1N1 pandemic, colloquially known as the Spanish Flu. Much like the Spanish Flu, which was observed to disproportionately impact young adults, it became clear in the early days of the coronavirus disease 2019 (COVID-19) pandemic that certain groups appeared to be at higher risk for severe illness once infected. One such group that immediately came to the forefront and garnered international attention was patients with preexisting cardiovascular disease. Here, we examine the available literature describing the interaction of COVID-19 with a myriad of cardiovascular conditions and diseases, paying particular attention to patients diagnosed with arrythmias, heart failure, and coronary artery disease. We further discuss the association of acute COVID-19 with de novo cardiovascular disease, including myocardial infarction due to coronary thrombosis, myocarditis, and new onset arrhythmias. We will evaluate various biochemical theories to explain these findings, including possible mechanisms of direct myocardial injury caused by the severe acute respiratory syndrome coronavirus-2 virus at the cellular level. Finally, we will discuss the strategies employed by numerous groups and governing bodies within the cardiovascular disease community to address the unprecedented challenges posed to the care of our most vulnerable patients, including heart transplant recipients, end-stage heart failure patients, and patients suffering from acute coronary syndromes, during the early days and height of the COVID-19 pandemic.

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Section: Heart Failure and Myocarditismentioning

confidence: 99%

Section: Heart Failure and Myocarditismentioning

confidence: 99%

Interaction of COVID-19 With Common Cardiovascular Disorders

Boulos

Freeman

Henry

et al. 2023

Circulation Research

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“…Other organs are often affected in the spectrum of COVID-19 manifestations, notably the cardiovascular system ( 132 , 133 ). Thrombosis, coronary infarction and stroke are more frequently observed in the setting of critical illness ( 134 ). Further evidence pointing toward endotheliopathy as a predictor of COVID-19 morbidity and mortality emerges from the strong association between pre-existing cardiovascular risk factors (i.e., advanced age, hypertension, and obesity) and the likelihood of disease progression ( 135 ).…”

Section: The Endotheliopathy Developed In Covid-19mentioning

confidence: 99%

Endothelial activation and damage as a common pathological substrate in different pathologies and cell therapy complications

Palomo,

Moreno-Castaño,

Salas

et al. 2023

Front. Med.

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The endothelium is a biologically active interface with multiple functions, some of them common throughout the vascular tree, and others that depend on its anatomical location. Endothelial cells are continually exposed to cellular and humoral factors, and to all those elements (biological, chemical, or hemodynamic) that circulate in blood at a certain time. It can adapt to different stimuli but this capability may be lost if the stimuli are strong enough and/or persistent in time. If the endothelium loses its adaptability it may become dysfunctional, becoming a potential real danger to the host. Endothelial dysfunction is present in multiple clinical conditions, such as chronic kidney disease, obesity, major depression, pregnancy-related complications, septic syndromes, COVID-19, and thrombotic microangiopathies, among other pathologies, but also in association with cell therapies, such as hematopoietic stem cell transplantation and treatment with chimeric antigen receptor T cells. In these diverse conditions, evidence suggests that the presence and severity of endothelial dysfunction correlate with the severity of the associated disease. More importantly, endothelial dysfunction has a strong diagnostic and prognostic value for the development of critical complications that, although may differ according to the underlying disease, have a vascular background in common. Our multidisciplinary team of women has devoted many years to exploring the role of the endothelium in association with the mentioned diseases and conditions. Our research group has characterized some of the mechanisms and also proposed biomarkers of endothelial damage. A better knowledge would provide therapeutic strategies either to prevent or to treat endothelial dysfunction.

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“…In the acute phase of severe COVID-19, the main cardiovascular complications are myocarditis, myocardial injury and infarction, heart failure, acute coronary syndrome, pulmonary hypertension, right ventricular dysfunction, and arrhythmia [ 7 , 8 ]. Of note, increasing evidence highlighted the incidence of cardiovascular complications as a long-term consequence of COVID-19 [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Evidence of Statins’ Protective Role against COVID-19 Hallmarks

et al. 2022

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Despite the progressions in COVID-19 understanding, the optimization of patient-specific therapies remains a challenge. Statins, the most widely prescribed lipid-lowering drugs, received considerable attention due to their pleiotropic effects, encompassing lipid metabolism control and immunomodulatory and anti-thrombotic effects. In COVID-19 patients, statins improve clinical outcomes, reducing Intensive Care Unit admission, the onset of ARDS, and in-hospital death. However, the safety of statins in COVID-19 patients has been debated, mainly for statins’ ability to induce the expression of the ACE2 receptor, the main entry route of SARS-CoV-2. Unfortunately, the dynamic of statins’ mechanism in COVID-19 disease and prevention remains elusive. Using different in vitro models expressing different levels of ACE2 receptor, we investigated the role of lipophilic and hydrophilic statins on ACE2 receptor expression and subcellular localization. We demonstrated that the statin-mediated increase of ACE2 receptor expression does not necessarily coincide with its localization in lipid rafts domains, particularly after treatments with the lipophilic atorvastatin that disrupt lipid rafts’ integrity. Through a proteomic array, we analyzed the cytokine patterns demonstrating that statins inhibit the release of cytokines and factors involved in mild to severe COVID-19 cases. The results obtained provide additional information to dissect the mechanism underlying the protective effects of statin use in COVID-19.

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The Cardiovascular Manifestations of COVID-19

Cited by 12 publications

References 75 publications

Interaction of COVID-19 With Common Cardiovascular Disorders

Interaction of COVID-19 With Common Cardiovascular Disorders

Endothelial activation and damage as a common pathological substrate in different pathologies and cell therapy complications

In Vitro Evidence of Statins’ Protective Role against COVID-19 Hallmarks

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