Cardiovascular Tropism and Sequelae of SARS-CoV-2 Infection

Dmytrenko, Oleksandr; Lavine, Kory J.

doi:10.3390/v14061137

Cited by 9 publications

(7 citation statements)

References 124 publications

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“…Reports have indicated that the ongoing evolution of SARS-CoV-2 variants is associated with various cardiovascular diseases ( 39 ). The acute phase of COVID-19 may involve cardiac manifestations including acute coronary syndrome, myocarditis, pericarditis, heart failure, and arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Subacute hemorrhagic pericardial tamponade after COVID-19 infection mimicking carcinomatous pericarditis: a case report

Yamamoto,

Kume,

Hashimoto

et al. 2024

Front. Cardiovasc. Med.

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BackgroundCoronavirus disease (COVID-19)-associated acute pericarditis has recently received much attention owing to its high frequency associated with pericardial tamponade (PT), showing unfavorable prognosis. However, early diagnosis and treatment remain challenging in cases of non-specific signs and symptoms.Case presentationA 64-year-old man was admitted to our hospital for acute osteomyelitis of the toes and was properly treated with antimicrobial agents. Three days after admission, the patient developed mild COVID-19 without pneumonia, for which early anti-COVID-19 agents were initiated. Nevertheless, the patient developed hemorrhagic PT due to acute pericarditis 2 weeks later, which was confirmed by cardiac magnetic resonance, requiring an urgent pericardiocentesis. Although cytological analysis of the hemorrhagic pericardial fluid strongly suggested adenocarcinoma, the atypical cells were eventually proven to be mesothelial cells with reactive atypia. Furthermore, lymph nodes swelling with abnormal 2-[18F]-fluoro-2-deoxy-D-glucose accumulation on imaging were suggestive of malignancy. However, biopsy examination revealed multiple non-caseating granulomas in the lymph node, unlikely due to malignancy. Eventually, the temporal association of the preceding COVID-19 with the occurrence of subacute PT without other identifiable cause led to a final diagnosis of COVID-19-associated acute pericarditis. With anti-inflammatory and corticosteroids treatment, the patient's symptoms involving the pericardial structure and function were completely resolved along with improvements in size of the affected lymphadenopathies.ConclusionsWe encountered a unique case of COVID-19-associated acute pericarditis exhibiting hemorrhagic PT. This case underscores the residual risk of delayed pericardial involvement even in patients with mild COVID-19 who receive early treatment, and the recognition that COVID-19 may cause various cytomorphological and histological features. Additionally, the importance of considering this rare entity as a cause of hemorrhagic pericardial effusions should be highlighted.

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Section: Discussionmentioning

confidence: 99%

Subacute hemorrhagic pericardial tamponade after COVID-19 infection mimicking carcinomatous pericarditis: a case report

Yamamoto,

Kume,

Hashimoto

et al. 2024

Front. Cardiovasc. Med.

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“…Although the exact pathophysiological events underlining this cardiovascular complication are not well known, the pathogenesis of COVID-19-induced myocardial inflammation has been proposed to be due to a combination of a direct virally induced cardiomyocyte damage, an overactive immune response to infected cardiac muscle cells and an overproduction of proinflammatory cytokines [ 14 , 21 ]. The similarity in SARS-CoV-2 infection with those induced by other coronaviruses, namely MERS-CoV and SARS-CoV-1, whose viral RNAs were detected in both animal and human heart samples, suggests that even the new member of the Coronaviridae family may possess cardiotropism, meaning that cardiovascular tissues are susceptible to SARS-CoV-2 infection [ 14 ]; SARS-CoV-2 tropism for myocardial cells might be an important determinant of COVID-19-related myocarditis and the viral persistence in the myocardium [ 76 ].…”

Section: Role Of Cardiovascular Factors (Ace2 and Raas) In The Pathog...mentioning

confidence: 99%

COVID-19-Induced Myocarditis: Pathophysiological Roles of ACE2 and Toll-like Receptors

Pannucci

Jefferson

Hampshire

et al. 2023

IJMS

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The clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection responsible for coronavirus disease 2019 (COVID-19) commonly include dyspnoea and fatigue, and they primarily involve the lungs. However, extra-pulmonary organ dysfunctions, particularly affecting the cardiovascular system, have also been observed following COVID-19 infection. In this context, several cardiac complications have been reported, including hypertension, thromboembolism, arrythmia and heart failure, with myocardial injury and myocarditis being the most frequent. These secondary myocardial inflammatory responses appear to be associated with a poorer disease course and increased mortality in patients with severe COVID-19. In addition, numerous episodes of myocarditis have been reported as a complication of COVID-19 mRNA vaccinations, especially in young adult males. Changes in the cell surface expression of angiotensin-converting enzyme 2 (ACE2) and direct injury to cardiomyocytes resulting from exaggerated immune responses to COVID-19 are just some of the mechanisms that may explain the pathogenesis of COVID-19-induced myocarditis. Here, we review the pathophysiological mechanisms underlying myocarditis associated with COVID-19 infection, with a particular focus on the involvement of ACE2 and Toll-like receptors (TLRs).

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“…También se ha observado afectación vascular, manifestándose como embolia pulmonar, trombosis venosa profunda, accidentes cerebrovasculares e isquemia de extremidades 15,16 . El virus tiene un claro tropismo por el sistema cardiovascular y es capaz de infectar cardiomiocitos y pericitos, causando una pérdida de la estructura del sarcómero y muerte celular 17 . Adicionalmente, la COVID-19 puede inducir daño directo al miocardio debido a hipoxemia, hipercoagulabilidad que conduce a trombosis, disfunción microvascular y una tormenta de citocinas, resultando en la desestabilización de la placa aterosclerótica 18 .…”

Section: Introductionunclassified

Caracterización de pacientes con síndrome coronario agudo e infección por SARS-CoV-2

Navarro-Navajas,

Salazar-Sierra,

Bustos-Martínez

et al. 2024

RPERC

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Antecedentes: Estudios previos sugieren una asociación entre la COVID-19 y el síndrome coronario agudo (SCA), aunque las características clínicas y angiográficas de estos pacientes no han sido ampliamente descritas. Objetivo: Describir las características clínicas y angiográficas de pacientes con SCA y prueba positiva para SARS-CoV-2 que requirieron angiografía coronaria en un hospital de Bogotá, Colombia. Método: Estudio descriptivo y transversal en adultos ingresados en un hospital colombiano entre el 6 de marzo y el 31 de agosto de 2020, diagnosticados con SCA y prueba RT-PCR positiva para SARS-CoV-2, o que desarrollaron SCA hasta 14 días después de una prueba positiva. Resultados: La población estudiada tuvo una edad promedio de 65 ± 13,9 años y el 59% era de sexo masculino. El infarto de miocardio sin elevación del segmento ST fue el diagnóstico más común (46%, n = 12), seguido del infarto de miocardio con elevación del segmento ST (35%, n = 10) y la angina inestable (19%, n = 5). La arteriografía coronaria reveló lesiones ateroscleróticas en el 59% de los casos (n = 16), trombos suboclusivos en el 26% (n = 8) y trombos oclusivos en el 11% (n = 3). Conclusiones: La mayoría de las lesiones coronarias identificadas fueron ateroscleróticas y el 37% de los pacientes presentaron trombosis coronaria. Estos hallazgos sugieren que la COVID-19 podría inducir un estado de hipercoagulabilidad e inflamación, contribuyendo a la formación de trombos y a la desestabilización de las placas ateroscleróticas.

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Cardiovascular Tropism and Sequelae of SARS-CoV-2 Infection

Cited by 9 publications

References 124 publications

Subacute hemorrhagic pericardial tamponade after COVID-19 infection mimicking carcinomatous pericarditis: a case report

Subacute hemorrhagic pericardial tamponade after COVID-19 infection mimicking carcinomatous pericarditis: a case report

COVID-19-Induced Myocarditis: Pathophysiological Roles of ACE2 and Toll-like Receptors

Caracterización de pacientes con síndrome coronario agudo e infección por SARS-CoV-2

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