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        Cardiovascular disease and COVID-19: a position paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA)

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        CVR_CVD_COVID_revised2021_DG.pdf (PDF, 869Kb)(embargoed until 16/09/2022)
        Author
        Cenko, Edino
        Badimon, L
        Bugiardini, Raffaele
        Claeys, Marc
        de Luca, Giuseppe
        Wit, Cor de
        Derumeaux, Geneviève
        Dorobantu, Maria
        Duncker, Dirk
        Eringa, Etto
        Gorog, Diana
        Hassager, Christian
        Heinzel, Frank
        Huber, Kurt
        Manfrini, Olivia
        Milicic, Davor
        Oikonomou, Evangelos
        Padro, Teresa
        Trifunovic-Zamaklar, Danijela
        Vasilejevic-Pokrajcic, Zorana
        Vavlukis, Marija
        Attention
        2299/25103
        Abstract
        The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between SARS-CoV-2 and ACE2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as “post-acute COVID-19” may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance.
        Publication date
        2021-09-16
        Published in
        Cardiovascular Research
        Published version
        https://doi.org/10.1093/cvr/cvab298
        Other links
        http://hdl.handle.net/2299/25103
        Relations
        School of Life and Medical Sciences
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