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Características cardiopulmonares del COVID largo: desde las características moleculares e histopatológicas hasta las
Giovanni Cimmino1,2, Saverio D'Elia1,3, Mariarosaria Morello2
1Cardiology Unit, AOU Luigi Vanvitelli, 80138 Naples, Italy.
International journal of molecular sciences
|August 28, 2025
Resumen
El COVID prolongado causa problemas cardiovasculares y pulmonares persistentes debido a la inflamación y la coagulación. El diagnóstico temprano utilizando marcadores moleculares es clave para el manejo de estas complicaciones post-virales crónicas.
Área de la Ciencia:
- Cardiología
- Pulmonología
- Enfermedades infecciosas
- Inmunología
Sus antecedentes:
- El COVID largo es un síndrome post-viral persistente que afecta a los sistemas cardiovascular y pulmonar.
- Las alteraciones crónicas incluyen disfunción endotelial, inflamación microvascular y potencial persistencia viral en los tejidos.
- La inflamación sostenida (por ejemplo, IL-6 elevado) y la hiperreactividad plaquetaria promueven un estado protrombótico.
Objetivo del estudio:
- Investigar los mecanismos moleculares e histopatológicos subyacentes a las secuelas cardiopulmonares prolongadas del COVID.
- Destacar la necesidad de mejorar las estrategias de diagnóstico que integran marcadores moleculares y basados en tejidos.
- Hacer hincapié en la importancia de la identificación temprana y la atención multidisciplinaria para las complicaciones crónicas.
Principales métodos:
- Revisión de la evidencia emergente sobre las alteraciones crónicas después de la infección por SARS-CoV-2.
- Análisis de los mecanismos moleculares, incluidos los perfiles de citoquinas y la actividad plaquetaria.
- Correlación de los hallazgos moleculares con las manifestaciones clínicas y las imágenes de diagnóstico (IRM cardíaca) y los hallazgos de la biopsia.
Principales resultados:
- Mecanismos implicados en daño microvascular, tensión cardíaca y alteración del intercambio de gases.
- Las manifestaciones clínicas incluyen fatiga, disnea, molestias en el pecho y reducción de la capacidad de ejercicio.
- Se observan alteraciones cardiovasculares subclínicas como la inflamación del miocardio y la desregulación autónoma, incluso en pacientes no hospitalizados.
Conclusiones:
- La actividad inflamatoria y trombótica persistente son las características clave de las secuelas cardiopulmonares prolongadas de COVID.
- Los diagnósticos moleculares y basados en tejidos son cruciales para la estratificación del riesgo y las intervenciones específicas.
- La atención multidisciplinaria es esencial debido a la interdependencia de la fibrosis pulmonar y la disfunción cardíaca.
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