Rezumat
Introducere. COVID-19 este cauzat de un nou betacoronavirus
numit oficial de OMS drept SARS-CoV-2. Coronavirusurile
sunt virusuri cu acid ribonucleic cu o singură catenă
(ARN), cu proiecţii de suprafaţă, care corespund proteinelor
spike de suprafaţă. Virusul SARS-CoV-2, care provoacă infecţia COVID-19, a atins niveluri de pandemie în luna martie
2020. În absenţa vaccinurilor sau a tratamentului medical
curativ, COVID-19 manifestă un impact global fără precedent
asupra sănătăţii publice şi a serviciilor medicale. SARSCoV-
2 nu provoacă doar pneumonie virală, dar are implicaţii
majore asupra sistemului cardiovascular.
Material şi metode. A fost studiată literatura ştiinţifică
referitoare la infecţia cu noul virus SARS-CoV-2, care provoacă
infecţia COVID-19, şi implicaţiile cardiovasculare ale
acestuia. Materialul a fost sintetizat în baza articolelor internaţionale,
în limba engleză – studii randomizate, de cohortă,
cazuri clinice, publicate pe parcursul ultimului an şi
câteva articole mai vechi publicate in ultimii 3 ani. Articolele
au fost selectate din bazele de date PubMed şi Springer Link
după cuvintele cheie: „SARS-CoV-2”, „COVID-19”, „cardiovascular
system”, „cardiac disease”, „myocarditits”, „arrhythmia”,
„hypertension”, „acute coronary syndrome”, „chronic cardiac
damage”. Informaţia este prezentată sub formă de sinteză
narativă.
Rezultate. Pacienţii cu factori de risc cardiovasculari,
precum şi pacienţii cu boli cardiovasculare stabilite şi boli cerebrovasculare
au fost identificaţi ca fiind populaţii deosebit
de vulnerabile, cu morbiditate şi mortalitate crescută atunci
când suferă de COVID-19. O proporţie considerabilă a pacienţilor
pot dezvolta leziuni cardiace în contextul COVID-19,
care oferă un risc crescut de mortalitate intraspitalicească.
Pe lângă complicaţiile trombotice arteriale şi venoase, ce se
prezintă ca sindroame coronariene acute (SCA) şi tromboembolisme
venoase (TEV), miocardita joacă un rol important
în dezvoltarea insuficienţei cardiace (IC) acute. De asemenea,
a fost raportată o gamă largă de aritmii care complică evoluţia
COVID-19, incluzând potenţialele efecte pro-aritmice ale
tratamentului COVID-19 şi patologiile asociate.
Concluzii. Sindromul respirator acut sever coronavirus
2 (SARS-CoV-2), care provoacă boala coronavirus 2019 (COVID-
19), a atins niveluri de pandemie. Pacienţii cu factori de
risc cardiovasculari şi boli cardiovasculare stabilite, reprezintă
o populaţie vulnerabilă atunci când suferă de COVID-19,
prezentând un risc crescut de morbiditate şi mortalitate.
Introduction. COVID-19 is caused by a new beta-coronavirus,
officially named by the WHO as SARS-CoV-2. Coronaviruses
are single-stranded ribonucleic acid (RNA) viruses
with surface projections that correspond to surface spike
proteins. The SARS-CoV-2 virus that causes COVID-19 infection reached pandemic levels in March 2020. In the absence
of vaccines or curative medical treatment, COVID-19 has an
unprecedented global impact on public health and health
services. SARS-CoV-2 not only causes viral pneumonia, but
also has major implications for the cardiovascular system.
Material and methods. The scientific publications concerning
the new SARS-CoV-2 virus, that causes the COVID-19
infection and its cardiovascular implications, has been studied.
The material was synthesized based on international articles,
in English – implying randomized trials, cohort studies,
clinical cases, published during the last year and some
older articles published in the last 3 years. The articles were
selected from the PubMed and Springer Link databases by
keywords: “SARS-CoV-2”, “COVID-19”, “cardiovascular system”,
“cardiac disease”, “myocarditis”, “arrhythmia”, “hypertension”,
“acute coronary syndrome”, “chronic cardiac injury”. The information
is presented in the form of a narrative review.
Results. Patients with cardiovascular risk factors, as well
as the patients with established cardiovascular disease and
cerebrovascular disease, have been identified as particularly
vulnerable populations, with increased morbidity and mortality
when suffering from COVID-19. A considerable proportion
of patients may develop heart damage in the context
of COVID-19, which provides an increased risk of in-hospital
mortality. In addition to arterial and venous thrombotic
complications, which present as acute coronary syndromes
(ACS) and venous thromboembolisms (VTE), myocarditis
plays an important role in the development of acute heart
failure (HF). A wide range of arrhythmias, which complicates
the evolution of COVID-19, has also been reported, including
the potential pro-arrhythmic effects of COVID-19 treatment
and associated pathologies.
Conclusions. Severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) causing coronavirus disease 2019
(COVID-19), has reached pandemic levels. Patients with
established cardiovascular risk factors and cardiovascular
disease are a vulnerable population when suffering from
COVID-19, with an increased risk of morbidity and mortality.
