SARS-CoV-2 Infection Triggers Pro-Atherogenic Inflammatory Responses in Human Coronary Vessels

A study has provided significant insights into the impact of SARS-CoV-2, the virus causing COVID-19, on the cardiovascular system.

Here’s a detailed summary:

  1. Cardiovascular Complications in COVID-19: Patients with COVID-19 show an increased risk for ischemic cardiovascular complications, such as acute myocardial infarction (AMI) and stroke, up to a year after infection. This is primarily due to the systemic inflammatory response triggered by SARS-CoV-2. Interestingly, the risk of stroke is over seven times higher in COVID-19 patients compared to those with influenza​​.
  2. SARS-CoV-2 in Coronary Lesions: The study reports that SARS-CoV-2 viral RNA is detectable and actively replicates in coronary lesions from severe COVID-19 cases. This finding is crucial as it indicates the direct involvement of the virus in coronary vasculature and atherosclerotic plaques. The virus specifically targets plaque macrophages and shows a stronger inclination towards infecting arterial lesions than the adjacent perivascular fat. This is correlated with the levels of macrophage infiltration in these areas​​.
  3. Increased Infection in Cholesterol-Loaded Macrophages: The study found that the entry of SARS-CoV-2 into cells is increased in cholesterol-loaded primary macrophages, partly depending on neuropilin-1. This suggests a link between cholesterol levels in macrophages and the susceptibility to SARS-CoV-2 infection.
  4. Triggering of Inflammatory Responses: SARS-CoV-2 induces a robust inflammatory response in both cultured macrophages and human atherosclerotic vascular explants. The virus triggers the secretion of cytokines known to provoke cardiovascular events, suggesting that SARS-CoV-2 infection can induce plaque inflammation. This inflammation could be a contributing factor in triggering acute cardiovascular complications and elevating long-term cardiovascular risk in COVID-19 patients​​​​.

In conclusion, the study highlights a critical aspect of COVID-19, underscoring the direct impact of SARS-CoV-2 on the coronary vasculature and its potential to exacerbate cardiovascular complications. This emphasizes the need for careful cardiovascular monitoring in COVID-19 patients, particularly those with pre-existing cardiovascular conditions.

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