SARS-CoV-2 induced myocarditis: Current knowledge about its molecular and pathophysiological mechanisms

Biocell

article

DOMENICO MARIA CARRETTA¹  MARINA DI DOMENICO²  ROBERTO LOVERO³  ROBERTO ARRIGONI⁴  ANGELIKA ELZBIETA WEGIERSKA⁵  MARIAROSARIA BOCCELLINO²  ANDREA BALLINI²  IOANNIS ALEXANDROS CHARITOS⁷  LUIGI SANTACROCE⁵ 

[1] AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Cardiology Unit, Policlinico University Hospital of Bari;Department of Precision Medicine, University of Campania “Luigi Vanvitelli”;AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Clinical Pathology Unit, Policlinico University Hospital of Bari;CNR Institute of Biomembranes;Department Interdisciplinary of Medicine, University of Bari “Aldo Moro”;School of Medicine, University of Bari “Aldo Moro”;Department of Emergency and Urgency, National Poisoning Centre, Riuniti University Hospital of Foggia

关键词: Viruses;    Infections;    SARS-CoV-2;    Pandemics;    Myocarditis;    Molecular diagnosis;   

DOI  :  10.32604/biocell.2022.020009

学科分类：仪器

来源: Biocell

【 摘 要 】

The existence of an inflammatory process in the heart muscle, related to a progressive worsening of myocardialfunction, different etiopathogenetic mechanisms concur and often overlap, thus making the diagnosis and the therapeuticapproach complex. As the COVID-19 pandemic progresses, the effects of the disease on the organ systems and inparticular on the cardiovascular system are becoming more and more profound. Cardiac involvement is a well-knownevent with a high percentage of findings in the heart’s magnetic field, even in asymptomatic areas. There arenumerous uncertainties regarding their evolution, in the long and short term, due not only to a difficult to determinethe varied clinical expression and the rarely performed intramyocardial biopsy which additionally presents diagnosticproblems but also in part to different clinical prognosis. Today, the new SARS-CoV-2 virus that uses the angiotensinconverting enzyme 2 (ACE2) which is present at high levels in myocardial cells as its entrance it can create evensevere heart injury. The pathophysiology in all of these cases can involve multiple immune and non-immunemechanisms within organs and vessels and can be occur in the clinical phases. Possible mechanisms of direct andindirect myocardial infarction in patients with COVID-19 include additional lesion and oxygen-rich and generalizedinflammation response with myocardial immune hyperactivity (myocarditis). Therefore, these can occur through theexcessive release of cytokines, the presence of thrombocytopenia, endocrine damage, heart failure, arrhythmias andmore. Patients can show average signs of myocardial damage, and some develop spontaneous cardiac complications,such as heart failure, arrhythmias and, rarely, rare cardiogenic disorders. Pathophysiology in all of these may involvemultiple mechanisms within the cytokine cephalic membrane, endocrine damage and thrombogenicity. The diagnosisof this myocardial injuri is mainly based on the myocardial enzyme troponin. This viewpoint paper explains today’sknowledge on viral myocarditis, in particular that from SARS-CoV-2 infection, if there is a connection with otherpossible biomolecular pathogenetic factors that can influence its natural course. In fact, it is for this reason that thepathogenetic mechanisms are analyzed and described. At the same time, its possible interaction with other parametersthat are documented risk factors for cardiovascular disease was examined. Although these biomolecular findings weremainly related to necrotic parts of the myocardium, it is important to recognize that myocardial damage early for abetter approach and prognosis.

【 授权许可】

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