Daño cardiovascular en la COVID-19: Una extensión de la enfermedad pulmonar

Luis A. Ochoa Montes, Daisy Ferrer Marrero

Texto completo:

HTML PDF PDF (English)

Resumen

Ante la ocurrencia de un brote de neumonía en 59 pacientes sospechosos en un mercado local de mariscos en Wuhan, China, el 1 de diciembre de 2019 fue confirmado por el laboratorio el primer caso de un nuevo coronavirus, hasta entonces desconocido. El 7 de enero de 2020 fue identificado un nuevo tipo de virus de la familia Coronaviridae denominado SARS-CoV-2, agente causal de la enfermedad conocida como COVID-19. Los escasos informes iniciales limitaban la afectación al tracto respiratorio inferior. Con el progreso de la enfermedad y el cúmulo de evidencia científica, se demostró el papel fundamental que desempeña la afectación cardiovascular en el desarrollo y pronóstico de la infección. La edad es un predictor independiente de mortalidad y se ha demostrado una asociación entre la enfermedad cardiovascular preexistente y las formas graves de la enfermedad. La afectación cardiovascular puede ser directa o indirecta, se destacan el daño miocárdico agudo, la miocarditis, el infarto agudo de miocardio, la insuficiencia cardíaca, las arritmias y los eventos tromboembólicos venosos. Se añaden los efectos adversos del tratamiento de las complicaciones cardíacas y el ensayo con fármacos en los protocolos terapéuticos. En esta monografía se revisa el daño cardiovascular por la COVID-19.

Referencias

Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50. https://doi.org/10.1016/j.dsx.2020.03.013

Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798-800. http://dx.doi.org/10.1093/eurheartj/ehaa231

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-60. https://doi.org/10.1038/s41569-020-0360-5

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. http://dx.doi.org/10.1001/jama.2020.1585

Kahn JS, McIntosh K. History and recent advances in coronavirus discovery. Pediatr Infect Dis J. 2005;24(Supl 11):S223-7. https://doi.org/10.1097/01.inf.0000188166.17324.60

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. http://dx.doi.org/10.1016/S0140-6736(20)30183-5

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(18):2352-71. http://dx.doi.org/10.1016/j.jacc.2020.03.031

World Health Organization. Coronavirus Disease (COVID-19) Dashboard. Reporte 23 de diciembre de 2020 [Internet]. Ginebra: Organización Mundial de la Salud; 2020 [citado 10 Dic 2020]. Disponible en: https://covid19.who.int/

Sitio oficial del Ministerio de Salud pública (MINSAP). Información oficial sobre Coronavirus. Reporte 23 de diciembre de 2020 [Internet]. La Habana: 2020 [citado 10 Dic 2020]. Disponible en: https://salud.msp.gob.cu/

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. http://dx.doi.org/10.1001/jama.2020.2648

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. http://dx.doi.org/10.1001/jamainternmed.2020.0994

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62.https://doi.org/10.1016/S0140-6736(20)30566-3

Worldometer. Coronavirus (COVID-19) Mortality Rate [Internet]. Worldometer. [citado 10 Dic 2020]. Disponible en: https://www.worldometers.info/coronavirus/coronavirus-death-rate/

Zidar DA, Al-Kindi SG, Liu Y, Krieger NI, Perzynski AT, Osnard M, et al. Association of Lymphopenia With Risk of Mortality Among Adults in the US General Population. JAMA Netw Open [Internet]. 2019 [citado 13 Oct 2020];2(12):e1916526. Disponible en: https://doi.org/10.1001/jamanetworkopen.2019.16526

Ganatra S, Hammond SP, Nohria A. The Novel Coronavirus Disease (COVID-19) Threat for Patients With Cardiovascular Disease and Cancer. JACC CardioOncol [Internet]. 2020 [citado 13 Oct 2020];2(2):350-5. Disponible en: https://doi.org/10.1016/j.jaccao.2020.03.001

Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-8. https://doi.org/10.1007/s00392-020-01626-9

Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res [Internet]. 2020 [citado 14 Oct 2020];7(1):11. Disponible en: http://dx.doi.org/10.1186/s40779-020-00240-0

Paz Ocaranza M, Riquelme JA, García L, Jalil JE, Chiong M, Santos RAS, et al. Counter-regulatory renin-angiotensin system in cardiovascular disease. Nat Rev Cardiol. 2020;17(2):116-29. http://dx.doi.org/10.1038/s41569-019-0244-8

Nicin L, Abplanalp WT, Mellentin H, Kattih B, Tombor L, John D, et al. Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts. Eur Heart J. 2020;41(19):1804-6. https://doi.org/10.1093/eurheartj/ehaa311

Soler MJ, Lloveras J, Batlle D. Enzima conversiva de la angiotensina 2 y su papel emergente en la regulación del sistema renina-angiotensina. Med Clin (Barc). 2008;131(6):230-6. https://doi.org/10.1157/13124619

de la Torre Fonseca LM. Lesión miocárdica en el paciente con COVID-19. CorSalud [Internet]. 2020 [citado 15 Oct 2020];12(2):171-83. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/623/1205

Ferrario CM, Jessup J, Chappell MC, Averill DB, Brosnihan KB, Tallant EA, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005;111(20):2605-10. https://doi.org/10.1161/circulationaha.104.510461

Oudit GY, Kassiri Z, Jiang C, Liu PP, Poutanen SM, Penninger JM, et al. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest. 2009;39(7):618-25. https://doi.org/10.1111/j.1365-2362.2009.02153.x

Figueroa Triana JF, Salas Márquez DA, Cabrera Silva JS, Alvarado Castro CC, Buitrago Sandoval AF. COVID-19 y enfermedad cardiovascular. Rev Colomb Card. 2020;27(3):166-74. https://doi.org/10.1016/j.rccar.2020.04.004

Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O, et al. Cryo-EM structure of the 2019-nCoV spike in the perfusion conformation. Science. 2020;367(6483):1260-3. https://doi.org/10.1126/science.abb2507

Diaz JH. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. J Travel Med [Internet]. 2020 [citado 18 Oct 2020];27(3):taaa041. Disponible en: http://dx.doi.org/10.1093/jtm/taaa041

Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020;8(4):e21. http://doi.org/10.1016/S2213-2600(20)30116-8

Esler M, Esler D. Can angiotensin receptor-block-ing drugs perhaps be harmful in the COVID-19 pandemic? J Hypertens. 2020;38(5):781-2. https://doi.org/10.1097/hjh.0000000000002450

López-Ponce de León JD, Cárdenas-Marín PA, Giraldo-González GC, Herrera-Escandón A. Coronavirus - COVID 19: Más allá de la enfermedad pulmonar, qué es y qué sabemos del vínculo con el sistema cardiovascular. Rev Colomb Cardiol. 2020;27(3):142-52. https://doi.org/10.1016/j.rccar.2020.04.006

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3

Prohías Martínez JA. Consideraciones para los cardiólogos que están en primera línea en la atención al COVID-19. Cuban Cardiol [Internet]. 2020 [citado 21 Oct 2020];26(2):e996. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/996/pdf

Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Consenso ESC 2018 sobre la cuarta definición universal del infarto de miocardio. Rev Esp Cardiol. 2019;72(1):72.e1-e27. https://doi.org/10.1016/j.recesp.2018.11.011

Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GB, Feit F, et al. Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011;124(13):1414-25. https://doi.org/10.1161/circulationaha.111.026542

Bugiardini R, Manfrini O, Pizzi C, Fontana F, Morgagni G. Endothelial function predicts future development of coronary artery disease: a study of women with chest pain and normal coronary angiograms. Circulation. 2004;109(21):2518-23. https://doi.org/10.1161/01.cir.0000128208.22378.e3

Barja LD, Fitz Maurice M, Chávez González E. Hidroxicloroquina y azitromicina: riesgo cardiovascular, prolongación de QTc y muerte súbita en el nuevo escenario de la pandemia por COVID-19. CorSalud [Internet]. 2020 [citado 21 Oct 2020];12(1):54-9. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/601/1108

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Eng J Med. 2020;382:1708-20. http://dx.doi.org/10.1056/NEJMoa2002032

Chatre C, Roubille F, Vernhet H, Jorgensen C, Pers YM. Cardiac complications attributed to chloroquine and hydroxychloroquine: a systematic review of the literature. Drug Saf. 2018;41(10):919-31. https://doi.org/10.1007/s40264-018-0689-4

Bonanad C, García-Blas S, Tarazona-Santabalbina FJ, Diez-Villanueva P, Ayesta A, Forés JS, et al. Coronavirus: la emergencia geriátrica de 2020. Documento conjunto de la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología y la Sociedad Española de Geriatría y Gerontología. Rev Esp Cardiol. 2020;73(7):569-76. https://doi.org/10.1016/j.recesp.2020.03.027

Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-10. https://doi.org/10.1001/jamacardio.2020.0950

Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J. 2021;42(2):206. https://doi.org/10.1093/eurheartj/ehaa190

Wong CK, Lam CW, Wu AK, Ip WK, Lee NL, Chan IH, et al. Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome. Clin Exp Immunol. 2004;136(1):95-103. http://dx.doi.org/10.1111/j.1365-2249.2004.02415.x

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. http://dx.doi.org/10.1016/S0140-6736(20)30628-0

Rivara MB, Bajwa EK, Januzzi JL, Gong MN, Thompson BT, Christiani DC. Prognostic significance of elevated cardiac troponin-T levels in acute respiratory distress syndrome patients. PLoS One [Internet]. 2012 [citado 28 Oct 2020];7(7):e40515. Disponible en: http://dx.doi.org/10.1371/journal.pone.0040515

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-8. https://doi.org/10.1001/jamacardio.2020.1017

Lippi G, Lavie CJ, Sanchis-Gomar F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis. Prog Cardiovasc Dis. 2020;63(3):390-1. https://doi.org/10.1016/j.pcad.2020.03.001

Gao L, Jiang D, Wen XS, Cheng XC, Sun M, He B, et al. Prognostic value of NT-proBNP in patients with severe COVID-19. Respir Res [Internet]. 2020 [citado 28 Oct 2020];21(1):83. Disponible en: https://doi.org/10.1186/s12931-020-01352-w

Goritsas C, Fasoulaki M, Paissios NP, Giakoumaki E, Alamanos Y, Nikolaou NI. Brain natriuretic peptide plasma levels as a marker of prognosis in patients with community acquired infection. Eur J Emerg Med. 2010;17(5):293-5. http://dx.doi.org/10.1097/MEJ.0b013e328332354b

Januzzi JL. Troponin and BNP Use in COVID-19 [Internet]. American College of Cardiology. 2020 [citado 30 Oct 2020]. Disponible en: https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19

Fried JA, Ramasubbu K, Bhatt R, Topkara VK, Clerkin KJ, Horn E, et al. The Variety of Cardiovascular Presentations of COVID-19. Circulation. 2020;141(23):1930-6. https://doi.org/10.1161/circulationaha.120.047164

Alhogbani T. Acute myocarditis associated with novel Middle East respiratory syndrome coronavirus. Ann Saudi Med. 2016;36(1):78-80. https://doi.org/10.5144/0256-4947.2016.78

Nguyen JL, Yang W, Ito K, Matte TD, Shaman J, Kinney PL. Seasonal Influenza Infections and Cardiovascular Disease Mortality. JAMA Cardiol. 2016;1(3):274-81. http://dx.doi.org/10.1001/jamacardio.2016.0433

Wei X, Fang Y, Hu H. Glucocorticoid and immunoglobulin to treat viral fulminant myocarditis. Eur Heart J. 2020;41(22):2122. https://doi.org/10.1093/eurheartj/ehaa357

Tian S, Xiong Y, Liu H, Niu L, Guo J, Liao M, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Mod Pathol. 2020;33(6):1007-14. https://doi.org/10.1038/s41379-020-0536-x

Ammirati E, Veronese G, Brambatti M, Merlo M, Cipriani M, Potena L, et al. Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction. J Am Coll Cardiol. 2019;74(3):299-311. https://doi.org/10.1016/j.jacc.2019.04.063

Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8. http://dx.doi. org/10.1007/s00134-020-05991-x

Kwong JC, Schwartz KL, Campitelli MA, Chung H, Crowcroft NS, Karnauchow T, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med. 2018;378(4):345-53. https://doi.org/10.1056/nejmoa1702090

Ochoa Montes LA, González Lugo M, Tamayo Vicente DN, Araujo González RE, Santos Medina M. Mortalidad pre hospitalaria en el Infarto agudo del miocardio. Variables asociadas. Rev Cuban Cardiol [Internet]. 2019 [citado 2 Nov 2020];25(3). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/903/pdf

Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, et al. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes [Internet]. 2020 [citado 2 Nov 2020];13(4):e006631. Disponible en: http://dx.doi.org/10.1161/CIRCOUTCOMES.120.006631

Cox CE. COVID-19 Poised to Upend the Cath Lab, ACC and SCAI Say. [Internet]. TCTMD (Cardiovascular Research Foundation). 2020 [citado 2 Nov 2020]. Disponible en: https://www.tctmd.com/news/covid-19-poised-upend-cath-lab-acc-and-scai-say

Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital. Intensive Care Med. 2020;46(6):1111-3. http://dx.doi.org/10.1007/s00134-020-05993-9

The Lancet Respiratory Medicine. COVID-19: delay, mitigate, and communicate. Lancet Respir Med. 2020;8(4):321. http://dx.doi.org/10.1016/S2213-2600(20)30128-4

Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. http://dx.doi.org/10.1093/eurheartj/ehx393

Mesa González M, Correa Padilla JM, Abreu Cruz AA. Complicaciones cardiovasculares en COVID-19. Boletín científico del CIMEQ [Internet]. 2020 [citado 6 Nov 2020];1(16):6. Disponible en: https://files.sld.cu/cimeq/files/2020/06/Bol-CCimeq-2020-1-16-pag5-6.pdf

Giudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ. Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19). Mayo Clin Proc. 2020;95(6):1213-21. https://doi.org/10.1016/j.mayocp.2020.03.024

Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854-87. http://dx.doi.org/10.1007/s00134-020-06022-5

Elfiky AA. Anti-HCV, nucleotide inhibitors, repurposing against COVID-19. Life Sci [Internet]. 2020 [citado 6 Nov 2020];248:117477. Disponible en: https://doi.org/10.1016/j.lfs.2020.117477

Alfonso Rodríguez E, Llerena Rojas LD, Rodríguez Nande LM. Consideraciones para pacientes con enfermedades cardiovasculares durante la pandemia de la COVID-19. Rev Cuban Invest Bioméd [Internet]. 2020 [citado 6 Nov 2020];39(3):e795. Disponible en: http://www.revibiomedica.sld.cu/index.php/ibi/article/view/795/734

Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72-3. http://doi.org/10.5582/bst.2020.01047

Choi Y, Lim HS, Chung D, Choi JG, Yoon D. Risk Evaluation of Azithromycin-Induced QT Prolongation in Real-World Practice. Biomed Res Int [Internet]. 2018 [citado 9 Nov 2020];2018:1574806. Disponible en: https://doi.org/10.1155/2018/1574806

Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488-94. http://dx.doi.org/10.1001/jama.2020.3204

Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):E131-E134. https://doi.org/10.1002/ajh.25774

Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. 2020;5(7):831-40. https://doi.org/10.1001/jamacardio.2020.1286

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. https://doi.org/10.1111/jth.14768

Enlaces refback

  • No hay ningún enlace refback.


Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.