COVID-19大流行中的心血管合并症

R. Tamrakar, K. Amgain, Ahmad Naeem Sajed
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摘要

目前,我们正处于由SARS-CoV-2病毒感染引起的COVID - 19疾病的全球大流行之中。它现在几乎已经蔓延到地球的每一个角落。医疗专业人员面临着管理这种感染的多种临床表现和多系统参与的挑战。尽管COVID-19疾病主要涉及呼吸系统,但在心血管系统中存在多种表现,这给治疗带来了独特的挑战。临床上,患者可能具有心肌炎、心力衰竭、急性心肌梗死、心律失常、血管血栓形成等特征。在这些表现中,最常见的机制是直接心肌损伤,而全身性炎症、氧供需不匹配、斑块破裂也被认为是可能的。此外,目前可用的数据表明,心血管相关表现导致发病率和死亡率增加。此外,有潜在心脏病的患者更容易患严重疾病和死亡。尽管目前COVID-19的治疗方案有限,但必须考虑这些治疗对这些患者的潜在心血管影响。有必要审查关于COVID-19疾病中心血管合并症含义的现有信息,以便我们对这一全球性问题有最新和更好的了解。本文综述了COVID-19的表现、心血管症状的病理生理机制,并讨论了心脏病患者在药物治疗和进一步治疗方面的具体问题。
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Cardiovascular Co-morbidity in COVID-19 Pandemic
At present, we are in the middle of a global pandemic due to COVID 19 disease caused by SARS-CoV-2 viral infection. It has now spread virtually to every corner of the globe. Medical professionals are faced with the challenge of managing diverse clinical manifestations and multisystem involvement of this infection. Although respiratory system is mainly involved COVID-19 disease, there have been diverse manifestations within the cardiovascular (CV) system that posing unique therapeutic challenges. Clinically, a patient may have features of myocarditis, heart failure, acute myocardial infarction, arrhythmia, and vascular thrombosis. Of these manifestations, the most common mechanism implicated is direct myocardial injury, whereas systemic inflammation, oxygen supply-demand mismatch, plaque rupture have also been suggested. Furthermore, current available data suggest cardiovascular related manifestations lead to increased morbidity and mortality. Also, patients with underlying cardiac conditions are more prone for severe disease and death. Although there are limited treatment options available for COVID-19 currently, it is imperative that the potential cardiovascular implications of these therapies are to be considered in these patients. There is need to review current available information regarding the implication of cardiovascular co-morbidity in COVID-19 disease so that we have uptodate and better understanding in this global problem. This review highlights the manifestations, pathophysiological mechanisms for cardiovascular manifestations of COVID-19 and address specific concerns of cardiac patients regarding medications and further management.
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