COVID-19の科学:心臓血管系への影響
Peter P Liu1,2, Alice Blet1,3,4, David Smyth1,2
1University of Ottawa Heart Institute (P.P.L., A.B., D.S.), University of Ottawa, Ontario, Canada.
Circulation
|April 16, 2020
まとめ
COVID-19 パンデミックは,重症急性呼吸器症候群コロナウイルス2 (SARS-CoV-2) が心血管系に影響を及ぼし,世界的に健康に影響を及ぼしています. 早期の指標と治療は,COVID-19のアウトカムを管理するために不可欠です.
科学分野:
- 心臓病科
- 感染症
- 免疫学
背景:
- COVID-19 パンデミックは,心血管疾患,高血圧,および関連疾患を患っている患者が不釣り合いの悪い結果を経験するなど,さまざまな臨床結果を示しています.
- 重症急性呼吸器症候群コロナウイルス2型 (SARS-CoV-2型) は,受容体結合領域の変異とSスパイクタンパク質のフーリン分裂部位の獲得により,高い感染性を示しています.
- 経膜プロテアゼセリン2によって促進されるアンジオテンシン変換酵素2受容体によるウイルスの内化は,COVID-19の症状と臓器機能不全と相関する.
研究 の 目的:
- COVID-19が心臓血管系に及ぼす多面的な影響を調査する.
- COVID-19の重症度における既存の状態の役割を強調する.
- COVID-19に対する免疫反応と潜在的な治療戦略について議論する.
主な方法:
- COVID-19患者,特に心血管関連疾患を有する患者の臨床結果の分析.
- 受容体結合と内化経路を含むウイルスのメカニズムのレビュー.
- リンパペニアやサイトカインストームなどの免疫反応の検査
- バイオマーカーの放出と炎症過程を含む心血管の関与の評価
主要な成果:
- COVID-19は心臓血管系に重大な影響を及ぼし,高濃度のトロポニンとナトリウレティックペプチドが示され,心筋炎症と機能不全を示唆する.
- ウイルス誘発のアンジオテンシン変換酵素2のダウンレギュレーションは,心血管リスクを悪化させる可能性があります.
- リンパ減少と高炎症を含む免疫機能の異常は,重症な結果と多臓器不全に寄与する.
- 血管の炎症は微血管病と血栓形成を引き起こし,心筋の炎症は心筋炎,心不全,不律,急性冠動脈症候群を引き起こします.
結論:
- 早期の予後指標と積極的なサポートケアは,COVID-19患者の回復を改善するために不可欠です.
- 心不全,不律,急性冠動脈症候群,血栓症の管理は極めて重要です.
- 証拠に基づくCOVID-19治療の開発には,継続的な世界的な協力が不可欠です.
- 抗体検査と効果的なワクチンは,パンデミックを制御し,将来の流行を防ぐために必要である.
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