Buletinul Academiei de Ştiinţe a Moldovei: Ştiinţe Medicale (Jul 2020)

COVID-19 și sistemul cardiovascular: concepte și viziuni actuale.

  • Mihail Popovici,
  • Eleonora Vataman,
  • Victoria Ivanov,
  • Marcel Abraş,
  • Lilia David,
  • Alexandru Carauş,
  • Vitalie Moscalu,
  • Nadejda Sapojnic,
  • Nadejda Diaconu,
  • Ana Plugaru,
  • Janna Cazacu,
  • Valeriu Cobeţ

Journal volume & issue
Vol. 65, no. 1
pp. 9 – 47

Abstract

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Background. SARS-CoV-2 action triggers and exacerbates cardiovascular disorders that underlines an intelligible necessity for a large researching of the inherent mechanisms and peculiarities needed for a diagnosis and depiction of the pathogenic therapy targets. Aim. This synthesis article embraced the known and plausible entities regarding the interface of COVID-19 and cardiovascular disturbances: from pathophysiology up to therapeutic approaches. Results. The main pathophysiological link between SARS-CoV-2 and circulatory homeostasis is based on Ang 1-7 deficiency, cytokinic storm and viremia basically leading to injury of cells having receptors for virus intracellular entering: ACE2 and CD209. Diagnostical tests are provided thereby of real time PCR and serological settings for immunoglobulins detection. There were noted particularities of the management of patients with STEMI and NSTEMI. Likewise, the evolution and treatment of the main cardiac arrhythmias in COVID-19 are tackled. Arterial hypertension, acute and chronic heart failure are also analyzed in patients infected by SARS-CoV-2. A special glance is thrown to problems of hemostasis in COVID-19 concerning thrombosis, fibrinolytic system disorders and treatment traits. The guidance concept of triage of the patients eligible to cardiac surgery in COVID-19 is emphasized also. Finally, this article comprises the specific elements of the pharmacological treatment of patients with cardiovascular disorders in COVID-19.