The Role of Endothelium in COVID-19

Abstract

The 2019 novel coronavirus, known as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19), is causing a global pandemic. The virus primarily affects the upper and lower respiratory tracts and raises the risk of a variety of non-pulmonary consequences, the most severe and possibly fatal of which are cardiovascular problems. Data show that almost one-third of the patients with a moderate or severe form of COVID-19 had preexisting cardiovascular comorbidities such as diabetes mellitus, obesity, hypertension, heart failure, or coronary artery disease. SARS-CoV2 causes hyper inflammation, hypoxia, apoptosis, and a renin–angiotensin system imbalance in a variety of cell types, primarily endothelial cells. Profound endothelial dysfunction associated with COVID-19 can be the cause of impaired organ perfusion that may generate acute myocardial injury, renal failure, and a procoagulant state resulting in thromboembolic events. We discuss the most recent results on the involvement of endothelial dysfunction in the pathogenesis of COVID-19 in patients with cardiometabolic diseases in this review. We also provide insights on treatments that may reduce the severity of this viral infection.

Impact of the COVID-19 Pandemic on Cardiology Emergency Department Visits

“…23) On the other hand, during the COVID-19 year, several proposed mechanisms of myocardial injury has been proposed: direct viral damage as a result of entry of the virus cell through the angiotensin-converting enzyme-2 (ACE2) receptor, endothelial cell damage, hypoxic injury, systemic inflammation, proinflammatory state, cytokine storm, interferon-mediated immune response, procoagulant state, and plaque destabilization. 24,25) The patients that are being treated out of hospital and requested to self-isolate may misinterpret the symptoms and neglect to seek medical care, which will cause CVD to be discovered later. Strength and limitations: Change in the cardiology ED visits is unlikely to be attributable to declines in the number of patients suffering from acute cardiovascular conditions.…”

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

“…In the context of a higher risk of severe COVID-19 [ 53 ] and lower titers of antibodies against SARS-CoV-2 after vaccination, seen in the patients treated with Rituximab, the European League Against Rheumatism (EULAR) recommends postponing the next cycle of treatment or replacing it, when possible, if the patient contacts the infection [ 11 ].…”

Neurological Consequences, Mental Health, Physical Care, and Appropriate Nutrition in Long-COVID-19

“…Furthermore, it is now scientifically established that residual consequences of SARS-CoV-2 infection present after negative swab can occur, not rare enough to induce physicians and scientists to identify a new pathology called long-COVID-19 (hereafter reported as “long-COVID”). Symptoms, which can affect multiple organs are fatigue, loss of weight and muscle strength, dyspnea, chest pain, cognitive disturbances, arthralgia, myocardial inflammation, vessel and kidney damages, which can lead to reduced quality of life (Ionescu et al 2021 ; Joshee et al 2022 ; Peterson et al 2021 ; Ronco et al 2020 ; Urso et al 2022 ; Yende and Parikh 2021 ; Nuzzo and Picone 2020 ; Nuzzo et al 2021a ); in the most severe cases, encephalitis can develop with inherent prognostic issues (Nuzzo et al 2021b ) (Fig. 1 ).…”