Issue: 2023, Vol. 28, No. 2

L. R. Pakhnova, O. A. Bashkina, M. A. Samotrueva

CARDIOVASCULAR PATHOLOGY: THE ROLE OF SARS-COV-2 IN DEVELOPMENT AND PROGRESSION

Keywords

COVID-19, endothelium, SARS-CoV-2, cardiovascular pathology, atherosclerosis, ACE2

Abstarct

The COVID-19 pandemic is a global problem in the health care system that leads to mortality and life-threatening complications worldwide. Initially, COVID-19 was considered only in the context of respiratory system involvement, but it soon became clear that the disease leads to serious consequences for various systems, including the cardiovascular system. On the other hand, clinical data indicate that the presence of chronic diseases in the patient exacerbates the course and outcome of SARS-CoV-2 infection. Cardiovascular pathology in general, and atherosclerosis of the major and coronary arteries in particular, are caused by both the direct impact of the SARS-CoV-2 virus and the systemic inflammatory response of the vascular endothelium. Endothelial dysfunction is considered a hallmark of many human cardiovascular diseases, including atherosclerosis, hypertension, and diabetes, and endothelial dysfunction is also associated with a severe course of COVID-19. SARS-CoV-2 leads to hyperproduction of cytokines, blood clotting factors, and vasoactive molecules, causing damage to the endothelial lining of blood vessels, vasoconstriction, and platelet proliferation leading to thrombosis. The resulting cytokine storm leads to secretion of Th-cells which stimulate the migration of smooth muscle cells into the intima and the production of collagen, leading to the development or progression of atherosclerotic lesions. There is evidence of the association of endothelial cells with SARS-CoV-2 infection, including the expression of angiotensin-converting enzyme 2 (ACE2) receptors in the vasculature. Disruptions in the production and functioning of ACE2 may lead to various disorders, including atherosclerosis. In this context, endothelial dysfunction presents a particular interest for future research, including the early.

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