Doenças cardiovasculares associadas à Covid-19 – revisão de literatura/ Cardiovascular diseases associated with Covid-19 – a review of literature
DOI:
https://doi.org/10.34119/bjhrv5n2-299Keywords:
COVID-19, isquemia miocárdica, disfunção ventricular, arritmias cardíacas.Abstract
Em dezembro de 2019, casos de pneumonia de etiologia desconhecida surgiram em Wuhan, China, com características clínicas muito semelhantes a um quadro de pneumonia viral. Apesar de o quadro clínico ser predominante de sintomas respiratórios, há evidências de que a COVID-19 pode causar complicações cardíacas, com elevação dos biomarcadores de estresse miocárdico, arritmias e insuficiência cardíaca, com risco aumentado de mortalidade. Estudos mostraram que 12 a 19,7% dos pacientes sem doença cardíaca prévia evoluíram com injúria miocárdica e suas complicações durante o período de internação. O provável mecanismo da lesão cardíaca envolve a formação de microtrombos na vasculatura do miocárdio, downregulation dos receptores da ECA-2, hiperativação da cascata inflamatória e imune, disfunção endotelial, hipoxemia, hiperativação simpática ou disautonomia e distúrbios hidroeletrolíticos. Lesão pulmonar grave no contexto de SARS-CoV-2 pode levar à fibrose pulmonar, hipertensão arterial pulmonar, doença cardiovascular e alterações metabólicas, sendo todos estes, fatores de risco para o desenvolvimento de insuficiência de ventrículo direito, tendo em vista aumento da pós carga direita. O entendimento sobre as complicações cardiológicas decorrentes da COVID-19 não está totalmente esclarecido, porém diversos estudos demonstram que tal associação é significativa.
References
BHATIA HS et al. Subclinical left ventricular dysfunction in COVID-19. Int J Cardiol Heart Vasc. 2021;34:100770.
BHATLA A, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm. 2020;17(9):1439-1444.
CONNORS JM, LEVY JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-2040.
CORRALES-MEDINA VF, et al. Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. JAMA. 2015;313(3):264-274.
FARDMAN A, et al. Acute myocardial infarction in the Covid-19 era: Incidence, clinical characteristics and in-hospital outcomes-A multicenter registry. PLoS One. 2021;16(6):e0253524. Published 2021 Jun 18. doi:10.1371/journal.pone.0253524
FIGUEIREDO NETO JA, et al. Doença de Coronavírus-19 e o Miocárdio. Arq. bras. cardiol ; 114(6): 1051-1057, Jun., 2020.
GAWAŁKO M, et al. COVID-19 associated atrial fibrillation: Incidence, putative mechanisms and potential clinical implications. Int J Cardiol Heart Vasc. 2020;30:100631.
GUAN WJ, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708-1720.
GUAN, WJ et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547.
GUO YR, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Mil. Med. Res. 2020; 7(1):1–10.
HANAEI S, REZAEI N. COVID-19: Developing from an Outbreak to A Pandemic. Arch Med Res. 2020;51(6):582-584.
HANSEN CH, et al. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. Lancet. 2021 Mar 27;397(10280):1204-1212.
HUANG C, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.
KATSOULARIS I, et al. Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet. 2021;398(10300):599-607.
LOTFI M, HAMBLIN MR, REZAEI N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clin Chim Acta. 2020;508:254-266.
MCINTOSH, K. COVID-19: Epidemiology, virology, and prevention. UpToDate. 2022. Disponível em: < http://www.uptodate.com/online>. Acesso em: 27/0/2022.
PARK JF, BANERJEE S, UMAR S. In the eye of the storm: the right ventricle in COVID-19. Pulm Circ . 2020;10(3):2045894020936660.
PATERNOSTER G, et al. Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth . 2021;35(11):3319-3324.
PERICO L, et al. Immunity, endothelial injury and complement-induced coagulopathy in COVID-19. Nat Rev Nephrol. 2021;17(1):46-64.
PUNTMANN VO, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11):1265-1273.
SITAMMAGARI K, et al. Insights From Rapid Deployment of a "Virtual Hospital" as Standard Care During the COVID-19 Pandemic. Ann Intern Med. 2021;174(2):192-199.
SHARMA A, et al. Human iPSC-Derived Cardiomyocytes Are Susceptible to SARS-CoV-2 Infection. Cell Rep Med. 2020 Jul 21;1(4):100052.
SHI S, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802–810.
SILVA FML, et al. COVID-19 and heart: relationship of cardiac tropism of the new coronavirus in affected patients. Brazilian Journal of health Review. Braz. J. Hea. Rev, Curitiba. 2020; 3(6) :15720-15725.
TANG N, et al. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-847.
VARNEY JA, et al. COVID-19 and arrhythmia: An overview. J Cardiol. 2022;79(4):468-475.
WANG D, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069
ZHOU F, et al. Clinical Course and Risk Factors for Mortality of Adult Inpatients With COVID-19 in Wuhan, China: A Retrospective Cohort Study. Lancet, 395: 1054-1062, 2020.
