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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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
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Online Access:https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1044
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author John P. Cooke
John H. Connor
Abhishek Jain
author_facet John P. Cooke
John H. Connor
Abhishek Jain
author_sort John P. Cooke
collection DOAJ
description 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.
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spelling doaj-art-3dca5889cb0c4f4bad9e60d050957b402025-08-20T03:47:06ZengHouston Methodist DeBakey Heart & Vascular CenterMethodist DeBakey Cardiovascular Journal1947-61082021-12-01175536210.14797/mdcvj.10441087Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for EndotheliopathyJohn P. Cooke0https://orcid.org/0000-0003-0033-9138John H. Connor1https://orcid.org/0000-0002-8867-7256Abhishek Jain2https://orcid.org/0000-0003-2235-5139Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TXBoston University Medical Center and National Emerging Infectious Diseases Laboratories, Boston University, Boston, MATexas A&M University, College Station, TX, US; Texas A&M Health Science Center, Bryan, TXSARS-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.https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1044sars-cov-2endotheliumdeep venous thrombosispulmonary embolismmyocardial infarctioncerebrovascular attackdementiamyocarditisnitric oxide
spellingShingle John P. Cooke
John H. Connor
Abhishek Jain
Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
Methodist DeBakey Cardiovascular Journal
sars-cov-2
endothelium
deep venous thrombosis
pulmonary embolism
myocardial infarction
cerebrovascular attack
dementia
myocarditis
nitric oxide
title Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
title_full Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
title_fullStr Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
title_full_unstemmed Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
title_short Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy
title_sort acute and chronic cardiovascular manifestations of covid 19 role for endotheliopathy
topic sars-cov-2
endothelium
deep venous thrombosis
pulmonary embolism
myocardial infarction
cerebrovascular attack
dementia
myocarditis
nitric oxide
url https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1044
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AT abhishekjain acuteandchroniccardiovascularmanifestationsofcovid19roleforendotheliopathy