“When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review
Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory coronavirus-2 (SARS-CoV-2). Several explanations for the development of cardiovascular complications during and after acute COVID-19 infection have been hypothesized. The COVID-19 pandemic, caused by SARS-CoV-2, has...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2024-01-01
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| Series: | Balkan Medical Journal |
| Online Access: |
http://balkanmedicaljournal.org/text.php?lang=en&id=2564
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| _version_ | 1797361149504651264 |
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| author | Nicholas G. Kounis Christos Gogos Cesare de Gregorio Ming-Yow Hung Sophia N. Kounis Efthymios P. Tsounis Stelios F. Assimakopoulos Soheila Pourmasumi Virginia Mplani George Servos Periklis Dousdampanis Panagiotis Plotas Marina A. Michalaki Grigorios Tsigkas Gerasimos Grammatikopoulos Dimitrios Velissaris Ioanna Koniar |
| author_facet | Nicholas G. Kounis Christos Gogos Cesare de Gregorio Ming-Yow Hung Sophia N. Kounis Efthymios P. Tsounis Stelios F. Assimakopoulos Soheila Pourmasumi Virginia Mplani George Servos Periklis Dousdampanis Panagiotis Plotas Marina A. Michalaki Grigorios Tsigkas Gerasimos Grammatikopoulos Dimitrios Velissaris Ioanna Koniar |
| author_sort | Nicholas G. Kounis |
| collection | DOAJ |
| description | Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory coronavirus-2 (SARS-CoV-2). Several explanations for the development of cardiovascular complications during and after acute COVID-19 infection have been hypothesized. The COVID-19 pandemic, caused by SARS-CoV-2, has emerged as one of the deadliest pandemics in modern history. The myocardial injury in COVID-19 patients has been associated with coronary spasm, microthrombi formation, plaque rupture, hypoxic injury, or cytokine storm, which have the same pathophysiology as the three clinical variants of Kounis syndrome. The angiotensin-converting enzyme 2 (ACE2), renin-aldosterone system (RAAS), and kinin-kallikrein system are the main proposed mechanisms contributing to cardiovascular complications with the COVID-19 infection. ACE receptors can be found in the heart, blood vessels, endothelium, lungs, intestines, testes, neurons, and other human body parts. SARS-CoV-2 directly invades the endothelial cells with ACE2 receptors and constitutes the main pathway through which the virus enters the endothelial cells. This causes angiotensin II accumulation downregulation of the ACE2 receptors, resulting in prothrombotic effects, such as hemostatic imbalance via activation of the coagulation cascade, impaired fibrinolysis, thrombin generation, vasoconstriction, endothelial and platelet activation, and pro-inflammatory cytokine release. The KKS system typically causes vasodilation and regulates tissue repair, inflammation, cell proliferation, and platelet aggregation, but SARS-CoV-2 infection impairs such counterbalancing effects. This cascade results in cardiac arrhythmias, cardiac arrest, cardiomyopathy, cytokine storm, heart failure, ischemic myocardial injuries, microvascular disease, Kounis syndrome, prolonged COVID, myocardial fibrosis, myocarditis, new-onset hypertension, pericarditis, postural orthostatic tachycardia syndrome, pulmonary hypertension, stroke, Takotsubo syndrome, venous thromboembolism, and thrombocytopenia. In this narrative review, we describe and elucidate when, where, and how COVID-19 affects the human cardiovascular system in various parts of the human body that are vulnerable in every patient category, including children and athletes. |
| first_indexed | 2024-03-08T15:49:49Z |
| format | Article |
| id | doaj.art-729a7d5bcb9a4a21a59cc5d17c2d63c1 |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-03-08T15:49:49Z |
| publishDate | 2024-01-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-729a7d5bcb9a4a21a59cc5d17c2d63c12024-01-09T06:36:24ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312024-01-0141172210.4274/balkanmedj.galenos.2023.2023-10-2513049054“When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative ReviewNicholas G. Kounis0Christos Gogos1Cesare de Gregorio2Ming-Yow Hung3Sophia N. Kounis4Efthymios P. Tsounis5Stelios F. Assimakopoulos6Soheila Pourmasumi7Virginia Mplani8George Servos9Periklis Dousdampanis10Panagiotis Plotas11Marina A. Michalaki12Grigorios Tsigkas13Gerasimos Grammatikopoulos14Dimitrios Velissaris15Ioanna Koniar16 Department of Cardiology, University of Patras Medical School, Rio, Greece Clinic of Cardiology, COVID-19 Unit, Papageorgiou General Hospital, Pavlos Melas, Greece Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan Speech Therapy Practice, Rio, Greece Division of Gastroenterology, Department of Internal Medicine, Medical School, University Hospital of Patras, Rio, Greece Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Rio, Greece Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Intensive Care Unit, Patras University Hospital, Rio, Greece Pediatric Cardiology Unit, “P. & A. Kyriakou” Children’s Hospital, Athina, Greece Department of Nephrology, Saint Andrews State General Hospital, Patras, Greece Department of Cardiology, University of Patras Medical School, Rio, Greece Department of Internal Medicine, Division of Endocrinology, University of Patras, School of Health Sciences, Rio, Greece Department of Cardiology, University of Patras Medical School, Rio, Greece Private Practice Neuroncenter, Neuron Neurology Center, Rio, Greece Department of Internal Medicine, University of Patras Medical School, Rio, Greece Electrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory coronavirus-2 (SARS-CoV-2). Several explanations for the development of cardiovascular complications during and after acute COVID-19 infection have been hypothesized. The COVID-19 pandemic, caused by SARS-CoV-2, has emerged as one of the deadliest pandemics in modern history. The myocardial injury in COVID-19 patients has been associated with coronary spasm, microthrombi formation, plaque rupture, hypoxic injury, or cytokine storm, which have the same pathophysiology as the three clinical variants of Kounis syndrome. The angiotensin-converting enzyme 2 (ACE2), renin-aldosterone system (RAAS), and kinin-kallikrein system are the main proposed mechanisms contributing to cardiovascular complications with the COVID-19 infection. ACE receptors can be found in the heart, blood vessels, endothelium, lungs, intestines, testes, neurons, and other human body parts. SARS-CoV-2 directly invades the endothelial cells with ACE2 receptors and constitutes the main pathway through which the virus enters the endothelial cells. This causes angiotensin II accumulation downregulation of the ACE2 receptors, resulting in prothrombotic effects, such as hemostatic imbalance via activation of the coagulation cascade, impaired fibrinolysis, thrombin generation, vasoconstriction, endothelial and platelet activation, and pro-inflammatory cytokine release. The KKS system typically causes vasodilation and regulates tissue repair, inflammation, cell proliferation, and platelet aggregation, but SARS-CoV-2 infection impairs such counterbalancing effects. This cascade results in cardiac arrhythmias, cardiac arrest, cardiomyopathy, cytokine storm, heart failure, ischemic myocardial injuries, microvascular disease, Kounis syndrome, prolonged COVID, myocardial fibrosis, myocarditis, new-onset hypertension, pericarditis, postural orthostatic tachycardia syndrome, pulmonary hypertension, stroke, Takotsubo syndrome, venous thromboembolism, and thrombocytopenia. In this narrative review, we describe and elucidate when, where, and how COVID-19 affects the human cardiovascular system in various parts of the human body that are vulnerable in every patient category, including children and athletes. http://balkanmedicaljournal.org/text.php?lang=en&id=2564 |
| spellingShingle | Nicholas G. Kounis Christos Gogos Cesare de Gregorio Ming-Yow Hung Sophia N. Kounis Efthymios P. Tsounis Stelios F. Assimakopoulos Soheila Pourmasumi Virginia Mplani George Servos Periklis Dousdampanis Panagiotis Plotas Marina A. Michalaki Grigorios Tsigkas Gerasimos Grammatikopoulos Dimitrios Velissaris Ioanna Koniar “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review Balkan Medical Journal |
| title | “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review |
| title_full | “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review |
| title_fullStr | “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review |
| title_full_unstemmed | “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review |
| title_short | “When,” “Where,” and “How” of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review |
| title_sort | when where and how of sars cov 2 infection affects the human cardiovascular system a narrative review |
| url |
http://balkanmedicaljournal.org/text.php?lang=en&id=2564
|
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