TY - JOUR
T1 - Coronavirus Historical Perspective, Disease Mechanisms, and Clinical Outcomes
T2 - JACC Focus Seminar
AU - Pinney, Sean P.
AU - Giustino, Gennaro
AU - Halperin, Jonathan L.
AU - Mechanick, Jeffrey I.
AU - Neibart, Eric
AU - Olin, Jeffrey W.
AU - Rosenson, Robert S.
AU - Fuster, Valentin
N1 - Funding Information:
Dr. Pinney has received consulting fees from Abbott, CareDx, Medtronic, and Procyrion. Dr. Giustino has received consulting fees from Bristol Myers Squibb and Pfizer. Dr. Halperin has received consulting fees from Bayer AG HealthCare, Boehringer Ingelheim, Johnson & Johnson, and Ortho-McNeil-Janssen Pharmaceuticals; and served as a member of the Executive Steering Committee for the MARINER trial comparing anticoagulant strategies. Dr. Mechanick has received honoraria for lectures and program development from Abbott Nutrition. Dr. Olin is an Advisory Board member for Janssen Pharmaceuticals; and is on the Steering Committee for TRA2°P-TIMI 50. Dr. Rosenson has received research support from Akcea, Amgen, The Medicines Company, Novartis, and Regeneron; has received consulting fees from Amgen, C5, CVS Caremark, Corvidia, and The Medicines Company; has received honoraria for nonpromotional speaking from Amgen, Kowa, Pfizer, and Regeneron; has received royalties from UpToDate, Inc.; and has stock ownership in MediMergent, LLC. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Muthiah Vaduganathan, MD, served as Guest Associate Editor for this paper. Deepak L. Bhatt, MD, MPH, served as Guest Editor-in-Chief for this paper.
Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/10/27
Y1 - 2020/10/27
N2 - The emergence of a new coronavirus disease (coronavirus disease 2019 [COVID-19]) has raised global concerns regarding the health and safety of a vulnerable population. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incites a profound inflammatory response leading to tissue injury and organ failure. COVID-19 is characterized by the bidirectional relationship between inflammation and thrombosis. The clinical syndrome is propelled by inflammation producing acute lung injury, large-vessel thrombosis, and in situ microthrombi that may contribute to organ failure. Myocardial injury is common, but true myocarditis is rare. Elderly patients, those with established cardiovascular disease, and mechanically ventilated patients face the highest mortality risk. Therapies for COVID-19 are evolving. The antiviral drug remdesivir, dexamethasone, transfusion of convalescent plasma, and use of antithrombotic therapy are promising. Most require additional prospective studies. Although most patients recover, those who survive severe illness may experience persistent physical and psychological disabilities.
AB - The emergence of a new coronavirus disease (coronavirus disease 2019 [COVID-19]) has raised global concerns regarding the health and safety of a vulnerable population. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incites a profound inflammatory response leading to tissue injury and organ failure. COVID-19 is characterized by the bidirectional relationship between inflammation and thrombosis. The clinical syndrome is propelled by inflammation producing acute lung injury, large-vessel thrombosis, and in situ microthrombi that may contribute to organ failure. Myocardial injury is common, but true myocarditis is rare. Elderly patients, those with established cardiovascular disease, and mechanically ventilated patients face the highest mortality risk. Therapies for COVID-19 are evolving. The antiviral drug remdesivir, dexamethasone, transfusion of convalescent plasma, and use of antithrombotic therapy are promising. Most require additional prospective studies. Although most patients recover, those who survive severe illness may experience persistent physical and psychological disabilities.
KW - COVID-19
KW - SARS-CoV-2
KW - cardiovascular disease
KW - inflammation
KW - thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85092348547&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.08.058
DO - 10.1016/j.jacc.2020.08.058
M3 - Review article
C2 - 33092736
AN - SCOPUS:85092348547
SN - 0735-1097
VL - 76
SP - 1999
EP - 2010
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 17
ER -