COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up

Tajbakhsh, Amir; Hayat, Seyed Mohammad Gheibi; Taghizadeh, Hajar; Akbari, Ali; Inabadi, Masoumeh; Savardashtaki, Amir; Johnston, Thomas P.; Sahebkar, Amirhossein

doi:10.1080/14787210.2020.1822737

Cited by 170 publications

(130 citation statements)

References 103 publications

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“…The main function of the kidneys is to remove wastes and excess water from the body. It is reported that patients with kidney disease often have low levels of vitamin D in their blood [ 105 , 106 ]. Furthermore, people with reduced kidney function develop alterations levels of phosphorus and calcium in the blood.…”

Section: Nutrients and Bioactive Compoundsmentioning

confidence: 99%

Kidney diseases and COVID-19 infection: causes and effect, supportive therapeutics and nutritional perspectives

Askari

Sanadgol

Azarnezhad

et al. 2021

Heliyon

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Recently, the novel coronavirus disease 2019 , has attracted the attention of scientists where it has a high mortality rate among older adults and individuals suffering from chronic diseases, such as chronic kidney diseases (CKD). It is important to elucidate molecular mechanisms by which COVID-19 affects the kidneys and accordingly develop proper nutritional and pharmacological strategies. Although numerous studies have recently recommended several approaches for the management of COVID-19 in CKD, its impact on patients with renal diseases remains the biggest challenge worldwide. In this paper, we review the most recent evidence regarding causality, potential nutritional supplements, therapeutic options, and management of COVID-19 infection in vulnerable individuals and patients with CKD. To date, there is no effective treatment for COVID-19-induced kidney dysfunction, and current treatments are yet limited to anti-inflammatory (e.g. ibuprofen) and anti-viral medications (e.g. Remdesivir, and Chloroquine/Hydroxychloroquine) that may increase the chance of treatment. In conclusion, the knowledge about kidney damage in COVID-19 is very limited, and this review improves our ability to introduce novel approaches for future clinical trials for this contiguous disease.

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Section: Nutrients and Bioactive Compoundsmentioning

confidence: 99%

Kidney diseases and COVID-19 infection: causes and effect, supportive therapeutics and nutritional perspectives

Askari

Sanadgol

Azarnezhad

et al. 2021

Heliyon

Self Cite

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show abstract

“…Patients who are hospitalised with COVID-19 and have cardiometabolic risk factors, such as type 2 diabetes, cardiovascular disease, and kidney disease, are at high risk for multiorgan failure and death, as well as a slower clinical recovery. [1][2][3][4][5][6][7] Given the dearth of efficacious therapies that reduce the risk of disease progression and major clinical events (currently limited only to dexamethasone in critically ill patients), 8 there is a large unmet need for additional treatment options. 9,10 SGLT2 inhibitors have been shown to reduce cardiovascular and kidney events in large trials of predominantly ambulatory patients with type 2 diabetes, cardiovascular disease, or kidney disease.…”

Section: Introductionmentioning

confidence: 99%

Dapagliflozin in patients with cardiometabolic risk factors hospitalised with COVID-19 (DARE-19): a randomised, double-blind, placebo-controlled, phase 3 trial

Kosiborod

Esterline

Furtado

et al. 2021

The Lancet Diabetes & Endocrinology

154

126

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Background COVID-19 can lead to multiorgan failure. Dapagliflozin, a SGLT2 inhibitor, has significant protective benefits for the heart and kidney. We aimed to see whether this agent might provide organ protection in patients with COVID-19 by affecting processes dysregulated during acute illness.Methods DARE-19 was a randomised, double-blind, placebo-controlled trial of patients hospitalised with COVID-19 and with at least one cardiometabolic risk factor (ie, hypertension, type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease). Patients critically ill at screening were excluded. Patients were randomly assigned 1:1 to dapagliflozin (10 mg daily orally) or matched placebo for 30 days. Dual primary outcomes were assessed in the intention-to-treat population: the outcome of prevention (time to new or worsened organ dysfunction or death), and the hierarchial composite outcome of recovery (change in clinical status by day 30). Safety outcomes, in patients who received at least one study medication dose, included serious adverse events, adverse events leading to discontinuation, and adverse events of interest. This study is registered with ClinicalTrials.gov, NCT04350593.

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“…Cytokine storm, direct viral damage and endotheliitis are all believed to be implicated in the cardiac manifestations of the disease, such as myocarditis, HF, and myocardial infarction. From a clinical perspective, the incidence of myocardial damage in COVID-19 patients has been estimated to be as high as 28%, related to poor prognosis [8]. Cardiac arrhythmias are more prevalent among critically ill patients with COVID-19, related not only to direct viral effects, but also to systemic inflammation and drug interactions [9].…”

Section: The Rationale Behind the Use Of Sglt2i In Covid-19mentioning

confidence: 99%

Sodium-glucose co-transporter 2 inhibitors in COVID-19: meeting at the crossroads between heart, diabetes and infectious diseases

et al. 2021

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Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new class of glucose-lowering agents which have changed the landscape of diabetes therapy, due to their remarkable cardiorenal protective properties. The attack of severe acute respiratory syndrome coronavirus 2 on the heart and kidneys shares similarities with diabetes; therefore, the notion that SGLT2i might have a role in the future management of Coronavirus Disease 2019 (COVID-19) is based on a solid pathophysiological hypothesis. SGLT2i have been proved to decrease the expression of proinflammatory cytokines, ameliorate oxidative stress and reduce sympathetic activity, thus resulting in downregulation of both systemic and adipose tissue inflammation. On the other hand, they have been linked to an increased risk of euglycemic diabetic ketoacidosis. Therefore, the efficacy and safety of SGLT2i in COVID-19 are still debatable and remain to be clarified by ongoing randomized trials, to assess whether the benefits of treatment with these drugs outweigh the potential risks.

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COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up

Cited by 170 publications

References 103 publications

Kidney diseases and COVID-19 infection: causes and effect, supportive therapeutics and nutritional perspectives

Kidney diseases and COVID-19 infection: causes and effect, supportive therapeutics and nutritional perspectives

Dapagliflozin in patients with cardiometabolic risk factors hospitalised with COVID-19 (DARE-19): a randomised, double-blind, placebo-controlled, phase 3 trial

Sodium-glucose co-transporter 2 inhibitors in COVID-19: meeting at the crossroads between heart, diabetes and infectious diseases

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