COVID-19与心血管并发症:急诊医学最新进展

Emergency and critical care medicine Pub Date : 2023-09-01 Epub Date: 2023-06-01 DOI:10.1097/ec9.0000000000000095
Jianli Zhao, Yaoli Xie, Zhijun Meng, Caihong Liu, Yalin Wu, Fujie Zhao, Xinliang Ma, Theodore A Christopher, Bernard J Lopez, Yajing Wang
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引用次数: 0

摘要

摘要2019冠状病毒病(新冠肺炎)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和SARS-CoV-2变种引起,已成为一种全球大流行,导致严重的发病率和死亡率。新冠肺炎重症病例以低氧血症、高炎症、肺部细胞因子风暴为特征。临床研究报告了新冠肺炎与心血管疾病(CVD)之间的关联。心血管疾病患者如果感染新冠肺炎,心脏损伤生物标志物进一步升高,往往会出现严重症状和死亡。此外,新冠肺炎本身可诱导和促进心血管疾病的发展,包括心肌炎、心律失常、急性冠状动脉综合征、心源性休克和静脉血栓栓塞。尽管严重急性呼吸系统综合征冠状病毒2型诱导的心脏损伤的直接病因尚不清楚,研究不足,但人们怀疑它与心肌炎、细胞因子介导的损伤、微血管损伤和应激相关心肌病有关。尽管疫苗接种为降低总体死亡率提供了最有效的方法,但适应的治疗模式和定期监测心脏损伤生物标志物对于改善有严重新冠肺炎风险的弱势人群的结果至关重要。在这篇综述中,我们重点介绍了新冠肺炎心血管并发症的临床和研究的最新进展,并提供了在急诊医学中治疗新冠肺炎心脏并发症的前景。
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COVID-19 and cardiovascular complications: updates of emergency medicine.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV-2 variants, has become a global pandemic resulting in significant morbidity and mortality. Severe cases of COVID-19 are characterized by hypoxemia, hyper-inflammation, cytokine storm in lung. Clinical studies have reported an association between COVID-19 and cardiovascular disease (CVD). Patients with CVD tend to develop severe symptoms and mortality if contracted COVID-19 with further elevations of cardiac injury biomarkers. Furthermore, COVID-19 itself can induce and promoted CVD development, including myocarditis, arrhythmia, acute coronary syndrome, cardiogenic shock, and venous thromboembolism. Although the direct etiology of SARS-CoV-2 induced cardiac injury remains unknown and under-investigated, it is suspected that it is related to myocarditis, cytokine-mediated injury, microvascular injury, and stress-related cardiomyopathy. Despite vaccinations having provided the most effective approach to reducing mortality overall, an adapted treatment paradigm and regular monitoring of cardiac injury biomarkers is critical for improving outcomes in vulnerable populations at risk for severe COVID-19. In this review, we focus on the latest progress in clinic and research on the cardiovascular complications of COVID-19 and provide a perspective of treating cardiac complications deriving from COVID-19 in Emergency Medicine.

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