Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy

Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy

SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), is associated with a bewildering array of cardiovascular manifestations, including myocardial infarction and stroke, myocarditis and heart failure, atrial and ventricular arrhythmias, venous thromboembolism, and microvascular disea...

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Bibliographic Details
Main Authors: John P. Cooke, John H. Connor, Abhishek Jain
Format: Article
Language:English
Published: Houston Methodist DeBakey Heart & Vascular Center 2021-12-01
Series:Methodist DeBakey Cardiovascular Journal
Subjects:
sars-cov-2
endothelium
deep venous thrombosis
pulmonary embolism
myocardial infarction
cerebrovascular attack
dementia
myocarditis
nitric oxide
Online Access:https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1044
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Summary:SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), is associated with a bewildering array of cardiovascular manifestations, including myocardial infarction and stroke, myocarditis and heart failure, atrial and ventricular arrhythmias, venous thromboembolism, and microvascular disease. Accumulating evidence indicates that a profound disturbance of endothelial homeostasis contributes to these conditions. Furthermore, the pulmonary infiltration and edema, and later pulmonary fibrosis, in patients with COVID-19 is promoted by endothelial alterations including the expression of endothelial adhesion molecules and chemokines, increased intercellular permeability, and endothelial-to-mesenchyme transitions. The cognitive disturbance occurring in this disease may also be due in part to an impairment of the blood-brain barrier. Venous thrombosis and pulmonary thromboembolism are most likely associated with an endothelial defect caused by circulating inflammatory cytokines and/or direct endothelial invasion by the virus. Endothelial-targeted therapies such as statins, nitric oxide donors, and antioxidants may be useful therapeutic adjuncts in COVID-19 by restoring endothelial homeostasis.
ISSN:1947-6108

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