Aortic Dissection and COVID-19: A Comprehensive Systematic Review

A study published in “Current Problems in Cardiology” provides a comprehensive systematic review of the relationship between COVID-19 and aortic dissection, a significant cardiovascular complication.

Here’s a detailed summary of the findings:

  1. Overview of COVID-19 and Cardiovascular Complications: Initially recognized as a respiratory disease, COVID-19 has also been linked to various cardiovascular issues, including aortic dissection. This study systematically reviews the literature to explore the potential connections between COVID-19 and the pathophysiology of aortic dissection​​.
  2. Increased Risk of Aortic Dissection in COVID-19: The study notes that COVID-19 increases the risk of several cardiovascular complications, including aortic dissection, which is often underrated in COVID-19 patients. Although there is an indication that the rate of aortic dissection has increased during the pandemic, comprehensive studies on its molecular basis in relation to COVID-19 are limited​​.
  3. Similarities in Molecular Pathways and Markers: The study identifies several molecular pathways and markers common between aortic dissection and COVID-19. For instance, Von Willebrand Factor (VWF) levels, indicative of endothelial cell activation, are elevated in COVID-19 patients, as are factors like Transforming Growth Factor Beta (TGF-b), Total Plasma Homocysteine Y (tHCy), and Matrix Metalloproteinases (MMPs). These factors are also correlated with Marfan Syndrome (MFS) and aortic dissection, suggesting a potential increase in the risk of aortic dissection in COVID-19 patients​​.
  4. Potential Role of COVID-19 in Aortic Root Dilation and Dissection: The study discusses how COVID-19 may increase the probability of aortic root dilation, leading to aortic dissection. This is linked to the elevated levels of TGF-b, particularly in severe cases of COVID-19. Additionally, higher levels of tHCy in COVID-19 patients are correlated with more severe disease manifestations and could be predictive of the severity of pneumonia.
  5. Further Research Needed: While the study highlights significant similarities in the pathophysiology of aortic dissection and COVID-19, there is insufficient evidence to establish a direct correlation with specific gene pathways like LOX and FBN1 in Marfan Syndrome patients. Future investigations are suggested to explore these potential connections further​​.

In summary, this systematic review sheds light on the intricate relationship between COVID-19 and aortic dissection, suggesting that COVID-19 may predispose patients to cardiovascular complications. The study calls for further research to fully understand the molecular mechanisms linking these conditions and to develop appropriate preventive and therapeutic strategies.

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