Mechanisms of COVID-19-induced cardiovascular disease: Is sepsis or exosome the missing link?

J Cell Physiol. 2021 May;236(5):3366-3382. doi: 10.1002/jcp.30109. Epub 2020 Oct 20.

Abstract

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has reached a pandemic level, spreading across the globe by affecting over 33 million people and causing over 1,009,270 deaths. SARS-CoV-2 is highly infectious with a high basic reproduction number (R0 ) of 2.2-5.7 that has led to its exponential spread. Besides, very little is known about it in terms of immunogenicity and its molecular targets. SARS-CoV-2 causes acute respiratory distress syndrome, followed by multiple organ failure and death in a small percentage of individuals. Cardiac injury has emerged as another dreaded outcome of COVID-19 complications. However, a thorough understanding of the pathogenesis of SARS-CoV-2 is lacking. In this review, we discuss the virus, possible mechanisms of COVID-19-induced cardiac injury, and potential therapeutic strategies, and we explore if exosomes could be targeted to treat symptoms of COVID-19. Furthermore, we discussed the virus-induced sepsis, which may be the cause of multiple organ failure, including myocardial injury.

Keywords: COVID-19; SARS-CoV-2; cardiovascular disease; exosomes; sepsis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • COVID-19* / complications
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / virology
  • Exosomes / pathology*
  • Humans
  • SARS-CoV-2 / pathogenicity*
  • Sepsis / virology*

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2