cardiovascular-agents and Disseminated-Intravascular-Coagulation

Since the outbreak of coronavirus disease 2019 (COVID-19) in 2019, it is gaining worldwide attention at the moment. Apart from respiratory manifestations, neurological dysfunction in COVID-19 patients, especially the occurrence of cerebrovascular diseases (CVD), has been intensively investigated. In this review, the effects of COVID-19 infection on CVD were summarized as follows: (I) angiotensin-converting enzyme 2 (ACE2) may be involved in the attack on vascular endothelial cells by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), leading to endothelial damage and increased subintimal inflammation, which are followed by hemorrhage or thrombosis; (II) SARS-CoV-2 could alter the expression/activity of ACE2, consequently resulting in the disruption of renin-angiotensin system which is associated with the occurrence and progression of atherosclerosis; (III) upregulation of neutrophil extracellular traps has been detected in COVID-19 patients, which is closely associated with immunothrombosis; (IV) the inflammatory cascade induced by SARS-CoV-2 often leads to hypercoagulability and promotes the formation and progress of atherosclerosis; (V) antiphospholipid antibodies are also detected in plasma of some severe cases, which aggravate the thrombosis through the formation of immune complexes; (VI) hyperglycemia in COVID-19 patients may trigger CVD by increasing oxidative stress and blood viscosity; (VII) the COVID-19 outbreak is a global emergency and causes psychological stress, which could be a potential risk factor of CVD as coagulation, and fibrinolysis may be affected. In this review, we aimed to further our understanding of CVD-associated COVID-19 infection, which could improve the therapeutic outcomes of patients. Personalized treatments should be offered to COVID-19 patients at greater risk for stroke in future clinical practice.

Topics: Anticoagulants; Antiviral Agents; Atherosclerosis; Cardiovascular Agents; COVID-19; COVID-19 Drug Treatment; Disseminated Intravascular Coagulation; Extracellular Traps; Hemorrhage; Humans; Hyperglycemia; Inflammation; Renin-Angiotensin System; SARS-CoV-2; Stroke; Thrombosis

Carried out in this study for the first time was the diagnosis and treatment per groups of degree of severity of the clinical course of infectious myocarditis. According to the classification of the New York Association of Cardiology (1964, 1973), there has been established a clear correlation between the gravity of the process course, hemodialysis and cardiac haemodynamics.

Topics: Blood Coagulation; Cardiovascular Agents; Communicable Diseases; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Hemodynamics; Humans; Lipid Peroxidation; Myocarditis

In Part II of this review, recent aspects in shock therapy are discussed. Treatment of an animal in a state of shock is not an easy task, it is time-consuming and expensive. The basic aims of shock therapy are to remove the inciting cause (wherever possible), to increase the circulating blood volume in order to stimulate the cardiac output and tissue perfusion (by infusion of fluids and eventually vasoactive substances), and to reduce or correct the injurious effects of shock (oxygenation, corticosteroids, antibiotics, energy or substrates, vasoactive substances, diuretics, regulation of the acid-base balance, stimulation of RES, and treatment of DIC).

Topics: Adrenal Cortex Hormones; Animals; Anti-Bacterial Agents; Blood Transfusion; Cardiovascular Agents; Combined Modality Therapy; Disseminated Intravascular Coagulation; Diuretics; Fluid Therapy; Hemostasis; Mononuclear Phagocyte System; Oxygen Inhalation Therapy; Plasma Substitutes; Shock