ABSTRACT
The pandemic of COVID-19 in worldwide causes recent millions of morbidity and mortality in all countries and is the most important challenge in the world in recent years. Coronavirus is a single-stranded RNA virus and infection with COVID-19 leads to acute respiratory distress syndrome, lung inflammation, cytokine storm, and death. The other complications include endothelial dysfunction, activation of coagulation, thromboembolic events, and vascular disease. Cardiovascular complications such as myocardial and stroke ischemia, pulmonary thromboembolism, systemic arterial, and deep vein thrombosis were reported. In this review, we presented immuno-pathological mechanisms and the effects of COVID-19 on the cardiovascular system, heart, vessels, coagulation system, and molecular glance of immuno-inflammation to the COVID-19's pathology on the cardiovascular system.
Subject(s)
COVID-19 , Cardiovascular Diseases , Thromboembolism , Humans , COVID-19/complications , Cardiovascular Diseases/complications , SARS-CoV-2 , Thromboembolism/etiology , Inflammation/complicationsABSTRACT
BACKGROUND: Primary percutaneous coronary intervention (PPCI) as the treatment of choice for STsegment elevation myocardial infarction (STEMI) should be rapidly performed. It is necessary to use preventive strategies during the coronavirus disease 2019 (COVID19) outbreak, which is an ongoing global concern. However, critical times in STEMI management may be influenced by the implementation of infection control protocols. AIMS: We aimed to investigate the impact of our dedicated COVID19 PPCI protocol on time components related to STEMI care and catheterization laboratory personnel safety. A subendpoint analysis to compare patient outcomes at a median time of 70 days during the pandemic with those of patients treated in the preceding year was another objective of our study. METHODS: Patients with STEMI who underwent PPCI were included in this study. Chest computed tomography (CT) and realtime reverse transcriptase-polymerase chain reaction (rRTPCR) tests were performed in patients suspected of having COVID19. A total of 178 patients admitted between February 29 and April 30, 2020 were compared with 146 patients admitted between March 1 and April 30, 2019. RESULTS: Severe acute respiratory syndrome coronavirus 2 infection was confirmed by rRTPCR in 7 cases. In 6 out of 7 patients, CT was indicative of COVID19. There were no differences between the study groups regarding critical time intervals for reperfusion in STEMI. The 70day mortality rate before and during the pandemic was 2.73% and 4.49%, respectively (P = 0.4). CONCLUSIONS: The implementation of the dedicated COVID19 PPCI protocol in patients with STEMI allowed us to achieve similar target times for reperfusion, shortterm clinical outcomes, and staff safety as in the prepandemic era.