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COVID-19 and atrial fibrillation: Intercepting lines.
Donniacuo, Maria; De Angelis, Antonella; Rafaniello, Concetta; Cianflone, Eleonora; Paolisso, Pasquale; Torella, Daniele; Sibilio, Gerolamo; Paolisso, Giuseppe; Castaldo, Giuseppe; Urbanek, Konrad; Rossi, Francesco; Berrino, Liberato; Cappetta, Donato.
  • Donniacuo M; Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • De Angelis A; Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • Rafaniello C; Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • Cianflone E; Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy.
  • Paolisso P; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium.
  • Torella D; Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
  • Sibilio G; Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy.
  • Paolisso G; Santa Maria delle Grazie Hospital, Pozzuoli, Italy.
  • Castaldo G; Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • Urbanek K; Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy.
  • Rossi F; CEINGE Advanced Biotechnologies, Naples, Italy.
  • Berrino L; Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy.
  • Cappetta D; CEINGE Advanced Biotechnologies, Naples, Italy.
Front Cardiovasc Med ; 10: 1093053, 2023.
Article in English | MEDLINE | ID: covidwho-2229567
ABSTRACT
Almost 20% of COVID-19 patients have a history of atrial fibrillation (AF), but also a new-onset AF represents a frequent complication in COVID-19. Clinical evidence demonstrates that COVID-19, by promoting the evolution of a prothrombotic state, increases the susceptibility to arrhythmic events during the infective stages and presumably during post-recovery. AF itself is the most frequent form of arrhythmia and is associated with substantial morbidity and mortality. One of the molecular factors involved in COVID-19-related AF episodes is the angiotensin-converting enzyme (ACE) 2 availability. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses ACE2 to enter and infect multiple cells. Atrial ACE2 internalization after binding to SARS-CoV-2 results in a raise of angiotensin (Ang) II, and in a suppression of cardioprotective Ang(1-7) formation, and thereby promoting cardiac hypertrophy, fibrosis and oxidative stress. Furthermore, several pharmacological agents used in COVID-19 patients may have a higher risk of inducing electrophysiological changes and cardiac dysfunction. Azithromycin, lopinavir/ritonavir, ibrutinib, and remdesivir, used in the treatment of COVID-19, may predispose to an increased risk of cardiac arrhythmia. In this review, putative mechanisms involved in COVID-19-related AF episodes and the cardiovascular safety profile of drugs used for the treatment of COVID-19 are summarized.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Front Cardiovasc Med Year: 2023 Document Type: Article Affiliation country: Fcvm.2023.1093053

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Front Cardiovasc Med Year: 2023 Document Type: Article Affiliation country: Fcvm.2023.1093053