Abstract
SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), is associated with a bewildering array of cardiovascular manifestations, including myocardial infarction and stroke, myocarditis and heart failure, atrial and ventricular arrhythmias, venous thromboembolism, and microvascular disease. Accumulating evidence indicates that a profound disturbance of endothelial homeostasis contributes to these conditions. Furthermore, the pulmonary infiltration and edema, and later pulmonary fibrosis, in patients with COVID-19 is promoted by endothelial alterations including the expression of endothelial adhesion molecules and chemokines, increased intercellular permeability, and endothelial-to-mesenchyme transitions. The cognitive disturbance occurring in this disease may also be due in part to an impairment of the blood-brain barrier. Venous thrombosis and pulmonary thromboembolism are most likely associated with an endothelial defect caused by circulating inflammatory cytokines and/or direct endothelial invasion by the virus. Endothelial-targeted therapies such as statins, nitric oxide donors, and antioxidants may be useful therapeutic adjuncts in COVID-19 by restoring endothelial homeostasis.
Original language | English (US) |
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Pages (from-to) | 53-62 |
Number of pages | 10 |
Journal | Methodist DeBakey cardiovascular journal |
Volume | 17 |
Issue number | 5 |
DOIs | |
State | Published - 2021 |
Keywords
- SARS-CoV-2
- cerebrovascular attack
- deep venous thrombosis
- dementia
- endothelium
- myocardial infarction
- myocarditis
- nitric oxide
- pulmonary embolism
ASJC Scopus subject areas
- Medicine(all)