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Review
. 2021 Feb;48(2):1763-1771.
doi: 10.1007/s11033-021-06148-9. Epub 2021 Jan 22.

The cardiovascular disorders and prognostic cardiac biomarkers in COVID-19

Xingjuan Shi  1 , Mengying Chen  2 , Yu Zhang  2
Affiliations
Review

The cardiovascular disorders and prognostic cardiac biomarkers in COVID-19

Xingjuan Shi et al. Mol Biol Rep. 2021 Feb.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to the outbreak of coronavirus disease 2019 (COVID-19), a worldwide epidemic disease affecting increasing number of patients. Although the virus primarily targets respiratory system, cardiovascular involvement has been reported in accumulating studies. In this review, we first describe the cardiac disorders in human with various types of CoV infection, and in animals infected with coronavirus. Particularly, we will focus on the association of cardiovascular disorders upon SARS-CoV-2 infection, and prognostic cardiac biomarkers in COVID-19. Besides, we will discuss the possible mechanisms underlying cardiac injury resulted from SARS-CoV-2 infection including direct myocardial injury caused by viral infection, reduced level of ACE2, and inflammatory response during infection. Improved understandings of cardiac disorders associated with COVID-19 might predict clinical outcome and provide insights into more rational treatment responses in clinical practice.

Keywords: COVID-19; Cardiovascular disorders; Hs-cTnI; NT-proBNP; Prognosis.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Diagram of the structure of SARS-CoV-2 and viral infection. a The SARS-CoV-2 genomic RNA (gRNA) is packaged by the structural proteins consisting of the spike (S) protein, nucleocapsid (N) protein, membrane (M) protein, and the envelope (E) protein to assemble progeny virion. b Furin, which mediates cleavage of the S glycoprotein, is crucial in viral entry into the host cells. c SARS-CoV-2 infection is regulated by the binding of S protein with ACE2 on the host cells, and the cleavage of S protein by furin. ADAM17 modulates the level of ACE2 on plasma membrane, and accelerates the secretion of ACE2. The cellular serine protease TMPRSS2 also facilitates the ACE2 mediated viral entry
Fig. 2
Fig. 2
The potential mechanisms of cardiac damage in COVID-19 might be direct injury of cardiomyocytes by SARS-CoV2, decreased level of ACE2 upon viral infection, and inflammatory response
See this image and copyright information in PMC

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