Abstract
A pandemic of historic impact, coronavirus disease 2019 (COVID-19) has potential consequences on the cardiovascular health of millions of people who survive infection worldwide. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the etiologic agent of COVID-19, can infect the heart, vascular tissues, and circulating cells through ACE2 (angiotensin-converting enzyme 2), the host cell receptor for the viral spike protein. Acute cardiac injury is a common extrapulmonary manifestation of COVID-19 with potential chronic consequences. This update provides a review of the clinical manifestations of cardiovascular involvement, potential direct SARS-CoV-2 and indirect immune response mechanisms impacting the cardiovascular system, and implications for the management of patients after recovery from acute COVID-19 infection.
Keywords: COVID-19; angiotensin-converting enzyme 2; inflammation; magnetic resonance imaging; thrombosis.
Publication types
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't
- Research Support, U.S. Gov't, Non-P.H.S.
- Review
MeSH terms
- Angiotensin-Converting Enzyme 2 / metabolism*
- Biomarkers / metabolism
- COVID-19 / complications
- COVID-19 / epidemiology
- COVID-19 / therapy
- COVID-19 / virology*
- Cardiomyopathies / virology
- Cardiovascular Diseases / virology*
- Gene Expression
- Humans
- Immune System / physiology
- Myocardium / enzymology
- Myocytes, Cardiac / enzymology
- Myocytes, Cardiac / virology*
- Neuropilin-1 / metabolism
- Platelet Activation
- RNA, Messenger / metabolism
- Renin-Angiotensin System / physiology
- Return to Sport
- Risk Factors
- SARS-CoV-2 / physiology*
- SARS-CoV-2 / ultrastructure
- Spike Glycoprotein, Coronavirus / metabolism
- Troponin / metabolism
- Ventricular Remodeling
- Virus Attachment
- Virus Internalization* / drug effects
Substances
- Biomarkers
- NRP1 protein, human
- RNA, Messenger
- Spike Glycoprotein, Coronavirus
- Troponin
- spike protein, SARS-CoV-2
- Neuropilin-1
- Angiotensin-Converting Enzyme 2