Medicus, Vol. 29 No. 2 COVID-19, 2020.
Pregledni rad
COVID-19 and Patients with Heart Failure
Filip Puškarić
Maja Čikeš
Sažetak
Angiotensin-converting enzyme 2 (ACE2) is a protein which serves as the entry point for SARS-CoV-2 into human cells. Although structurally similar to angiotensin-converting enzyme, it serves an antagonistic purpose in the renin-angiotensin-aldosterone system (RAAS), and has a different target molecule. The ACE2 protein is present in various human tissues, including the lung epithelium and myocardium. It is currently thought that cardiac manifestations of COVID-19 are primarily linked to vascular involvement in SARS-CoV-2 infection. Heart failure has been described in COVID-19 patients since the start of the pandemic, with a frequency of around 25%. Although at present there is insufficient data regarding the type of heart failure in COVID-19 patients, current available data suggests a more common occurrence of heart failure with reduced ejection fraction. Due to the role of the ACE2 protein in the RAAS, questions have arisen regarding the effect of medications that inhibit the aforementioned system (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers), on the susceptibility of patients treated with the said drugs to SARS-CoV-2 infection, as well as on the development of a more severe clinical course of the disease. Conversely, it is important to consider the dangers of discontinuing medications from this group of drugs in patients with heart failure. According to current insights, the use of these drugs does not increase susceptibility to SARS-CoV-2 infection, nor are they associated with an increased risk of developing a more severe or fatal clinical course of COVID-19; thus, continuation of therapy is recommended by leading cardiac societies.
Ključne riječi
COVID-19; heart failure; ACE2; RAAS inhibitors; ACE inhibitors
Hrčak ID:
244331
URI
Datum izdavanja:
30.9.2020.
Posjeta: 2.175 *