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
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, Non-P.H.S.
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Review
MeSH terms
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Angiotensin-Converting Enzyme 2 / metabolism*
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Biomarkers / metabolism
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COVID-19 / complications
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COVID-19 / epidemiology
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COVID-19 / therapy
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COVID-19 / virology*
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Cardiomyopathies / virology
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Cardiovascular Diseases / virology*
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Gene Expression
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Humans
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Immune System / physiology
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Myocardium / enzymology
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Myocytes, Cardiac / enzymology
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Myocytes, Cardiac / virology*
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Neuropilin-1 / metabolism
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Platelet Activation
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RNA, Messenger / metabolism
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Renin-Angiotensin System / physiology
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Return to Sport
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Risk Factors
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SARS-CoV-2 / physiology*
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SARS-CoV-2 / ultrastructure
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Spike Glycoprotein, Coronavirus / metabolism
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Troponin / metabolism
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Ventricular Remodeling
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Virus Attachment
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Virus Internalization* / drug effects
Substances
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Biomarkers
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NRP1 protein, human
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RNA, Messenger
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Spike Glycoprotein, Coronavirus
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Troponin
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spike protein, SARS-CoV-2
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Neuropilin-1
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Angiotensin-Converting Enzyme 2