Full Title
PNEI REVIEW
Publisher
FrancoAngeli
ISSN
2532-6147 (Printed Journal)
2532-2826 (Online Journal)
Journal Issue Number
2
Journal Issue Designation
2
Journal Issue Date
2022
Full Title
Post-Acute Covid-19 Syndrome: manifestazioni cardiovascolari in ottica Pnei e potenziale ruolo della terapia integrata
By (author)
First Page
92
Last Page
107
Language of text
Italian
Publication Date
2022/11
Copyright
2022 FrancoAngeli srl
Introduction or preface
La possibilità di un coinvolgimento cardiovascolare in corso di Covid-19 è emersa fin dall'esordio della pandemia. La Post-Acute Covid-19 Syndrome (PACS) è la persistenza di sintomi o complicanze oltre 4 settimane dall'esordio della malattia. Colpisce il 32-72% dei pazienti. Possono essere presenti dispnea (42-66%), palpitazioni (9-10,9%) e dolore toracico (5-21,7%). Scopo del presente lavoro è analizzare i principali meccanismi alla base del coinvolgimento cardiovascolare in fase acuta e post-acuta in ottica Pnei e presentare le possibilità offerte dalla terapia integrata. Risposta infiammatoria sistemica, infiammazione localizzata sia endoteliale che pericardica, disautonomia e disregolazione del sistema renina-angiotensina-aldosterone sono spesso presenti in maniera simultanea e amplificati dallo stress. Tali meccanismi si affiancano alla possibilità di un danno diretto ai cardiomiociti da parte del virus. I quadri cinici che ne originano sono variegati e complessi. Occorre pertanto tener conto dei molteplici fattori che influenzano la risposta individuale all'infezione e utilizzare un approccio terapeutico personalizzato, multisistemico, multidisciplinare e integrato. Particolare cura andrà posta alla nutrizione, al ripristino dell'eubiosi, alla graduale ripresa dell'attività fisica, all'approccio psicoterapico e alla cura degli aspetti socio-ambientali a cui eventualmente affiancare discipline corporee, pratiche respiratorie e tecniche di stimolazione vagale.
Unstructured Citation
Alschuler L., Weil A., Horwitz R., Stamets P., Chiasson A. M., Crocker R., & Mai- zes V. (2020). Integrative considerations
during the Covid-19 pandemic. Explore (New York, N.Y.), 16(6), 354–356.
https://doi.org/10.1016/j.explore.2020.03.007
Unstructured Citation
Alzahrani A.S., Mukhtar N., Aljomaiah A., Aljamei H., Bakhsh A., Alsudani N., Elsayed T., Alrashidi N., Fadel R., Alqahtani
E., Raef H., Butt M.I., & Sulaiman O. (2021). The Impact of Covid-19 Viral Infection on the Hypothala- mic-Pituitary-Adrenal
Axis. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical
Endocrinologists, 27(2), 83–89.
https://doi.org/10.1016/j.eprac.2020.10.014
Unstructured Citation
Barker-Davies R. M., O’Sullivan O., Senaratne K., Baker P., Cranley M., Dharm-Datta S., Ellis H., Goodall D., Gough M., Lewis
S., Norman J., Papadopoulou T., Roscoe D., Sherwood D., Turner P., Walker T., Mistlin A., Phillip R., Nicol A.M., Bennett
A.N., & Bahadur S. (2020). The Stanford Hall consensus statement for post-Covid-19 rehabilita- tion. British Journal of Sports
Medicine, 54(16), 949–959.
https://doi.org/10.1136/bjsports-2020-102596
Unstructured Citation
Beacon T.H., Delcuve G.P., & Davie J.R. (2021). Epigenetic regulation of ACE2, the receptor of the SARS-CoV-2 virus. Genome,
64(4), 386–399.
https://doi.org/10.1139/gen-2020-0124
Unstructured Citation
Bonaventura A., Vecchié A., Dagna L., Martinod K., Dixon D.L., Van Tassell B.W., Dentali F., Montecucco F., Massberg S., Levi
M., & Abbate A. (2021). Endothelial dy- sfunction and immunothrombosis as key pathogenic mechanisms in Covid-19. Nature Re-
views. Immunology, 21(5), 319–329.
https://doi.org/10.1038/s41577-021-00536-9
Unstructured Citation
Clemente-Suárez V.J., Ramos-Campo D.J., Mielgo-Ayuso J., Dalamitros A.A., Nikolai- dis P.A., Hormeño-Holgado A., & Tornero-Aguilera
J.F. (2021). Nutrition in the Actual Covid-19 Pandemic. A Narrative Review. Nutrients, 13(6), 1924.
https://doi.org/10.3390/nu13061924
Unstructured Citation
Davis H.E., Assaf G.S., McCorkell L., Wei H., Low R.J., Re’em Y., Redfield S., Austin J.P., & Akrami A. (2021). Characterizing
long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine, 38, 101019.
https://doi.org/10.1016/j.eclinm.2021.101019
Unstructured Citation
Guilmot A., Maldonado Slootjes S., Sellimi A., Bronchain M., Hanseeuw B., Belkhir L., Yombi J.C., De Greef J., Pothen L.,
Yildiz H., Duprez T., Fillée C., Anantharajah A., Capes A., Hantson P., Jacquerye P., Raymackers J.M., London F., El Sankari
S., Ivanoiu A., Maggi P., & van Pesch V. (2021). Immune-mediated neurological syndro- mes in SARS-CoV-2-infected patients.
Journal of Neurology, 268(3), 751–757.
https://doi.org/10.1007/s00415-020-10108-x
Unstructured Citation
Hilpert K., & Mikut R. (2021). Is There a Connection Between Gut Microbiome Dysbiosis Occurring in Covid-19 Patients and Post-Covid-19
Symptoms?. Frontiers in Microbiology, 12, 732838.
https://doi.org/10.3389/fmicb.2021.732838
Unstructured Citation
Huang Y., Tan C., Wu J., Chen M., Wang Z., Luo L., Zhou X., Liu X., Huang X., Yuan S., Chen C., Gao F., Huang J., Shan H.,
& Liu J. (2020). Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Respiratory Research,
21(1), 163.
https://doi.org/10.1186/s12931-020-01429-6
Unstructured Citation
Islam F.M., Wu J., Jansson J., & Wilson D.P. (2012). Relative risk of cardiovascular di- sease among people living with HIV:
a systematic review and meta-analysis. HIV Medicine, 13(8), 453–468.
https://doi.org/10.1111/j.1468-1293.2012.00996.x
Unstructured Citation
Johansson M., Ståhlberg M., Runold M., Nygren-Bonnier M., Nilsson J., Olshansky B., Bruchfeld J., & Fedorowski A. (2021).
Long-Haul Post-Covid-19 Symptoms Presenting as a Variant of Postural Orthostatic Tachycardia Syndrome: The Swedish Experience.
JACC. Case Reports, 3(4), 573–580.
https://doi.org/10.1016/j.jaccas.2021.01.009
Unstructured Citation
Lazzerini P.E., Hamilton R.M., & Boutjdir M. (2019). Editorial: Cardioimmunology: In- flammation and Immunity in Cardiovascular
Disease. Frontiers in Cardiovascular Medicine, 6, 181.
https://doi.org/10.3389/fcvm.2019.00181
Unstructured Citation
Lin I.M., Wang S.Y., Fan S.Y., Peper E., Chen S.P., & Huang C.Y. (2020). A Single Ses- sion of Heart Rate Variability Biofeedback
Produced Greater Increases in Heart Rate Varia- bility Than Autogenic Training. Applied psychophysiology and Biofeedback,
45(4), 343–350.
https://doi.org/10.1007/s10484-020-09483-y
Unstructured Citation
Lindner D., Fitzek A., Bräuninger H., Aleshcheva G., Edler C., Meissner K., Scherschel K., Kirchhof P., Escher F., Schultheiss
H.P., Blankenberg S., Püschel K., & Westermann D. (2020). Association of Cardiac Infection With SARS-CoV-2 in Con- firmed
Covid-19 Autopsy Cases. JAMA Cardiology, 5(11), 1281–1285.
https://doi.org/10.1001/jamacardio.2020.3551
Unstructured Citation
Lionetti V., Bollini S., Coppini R., Gerbino A., Ghigo A., Iaccarino G., Madonna R., Mangiacapra F., Miragoli M., Moccia,
F., Munaron L., Pagliaro P., Parenti A., Pa- squa T., Penna C., Quaini F., Rocca C., Samaja M., Sartiani L., Soda T., Tocchetti
C.G., & Angelone, T. (2021). Understanding the heart-brain axis response in Covid-19 patients: A suggestive perspective for
therapeutic development. Pharmacological Rese- arch, 168, 105581.
https://doi.org/10.1016/j.phrs.2021.105581
Unstructured Citation
Madjid M., Safavi-Naeini P., Solomon S.D., & Vardeny O. (2020). Potential Ef- fects of Coronaviruses on the Cardiovascular
System: A Review. JAMA Cardiology, 5(7), 831–840.
https://doi.org/10.1001/jamacardio.2020.1286
Unstructured Citation
Mussa B.M., Srivastava A., & Verberne, A. (2021). Covid-19 and Neurological Impairment: Hypothalamic Circuits and Beyond.
Viruses, 13(3), 498.
https://doi.org/10.3390/v13030498
Unstructured Citation
Nagendra H.R. (2020). Yoga for Covid-19. International Journal of Yoga, 13(2), 87–88.
https://doi.org/10.4103/ijoy.IJOY_27_20
Unstructured Citation
Nalbandian A., Sehgal K., Gupta A., Madhavan M.V., McGroder C., Stevens J.S., Cook J.R., Nordvig A.S., Shalev D., Sehrawat
T.S., Ahluwalia N., Bikdeli B., Dietz D., Der-Nigoghossian C., Liyanage-Don N., Rosner G.F., Bernstein E.J., Mohan S., Beckley
A.A., Seres D.S., Choueiri T.K., Uriel N., Ausiello J.C., Accili D., Freedberg D.E., Baldwin M., Schwartz A., Brodie D., Garcia
C.K., Elkind M.S.V., Connors J.M., Bilezikian J.P., Landry D.W., & Wan E.Y. (2021). Post-acute Covid-19 syndrome. Nature Medicine,
27(4), 601–615.
https://doi.org/10.1038/s41591-021-01283-z
Unstructured Citation
Ortuno S., Jozwiak M., Mira J.P., & Nguyen L.S. (2021). Case Report: Ta- kotsubo Syndrome Associated With Novel Coronavirus
Disease 2019. Frontiers in Cardiovascular Medicine, 8, 614562.
https://doi.org/10.3389/fcvm.2021.614562
Unstructured Citation
Qin Z., Xiang K., Su D.F., Sun Y., & Liu X. (2021). Activation of the Choliner- gic Anti-Inflammatory Pathway as a Novel Therapeutic
Strategy for Covid-19. Frontiers in Immunology, 11, 595342.
https://doi.org/10.3389/fimmu.2020.595342
Unstructured Citation
Rios-Navarro C., Dios E., Forteza M.J., & Bodi V. (2021). Unraveling the thre- ad of uncontrolled immune response in Covid-19
and STEMI: an emerging need for knowledge sharing. American Journal of Physiology. Heart and Circulatory Physiology, 320(6),
H2240–H2254.
https://doi.org/10.1152/ajpheart.00934.2020
Unstructured Citation
Salman D., Vishnubala D., Le Feuvre P., Beaney T., Korgaonkar J., Majeed A., & McGregor A.H. (2021). Returning to physical
activity after Covid-19. BMJ (Clinical research ed.), 372, m4721.
https://doi.org/10.1136/bmj.m4721
Unstructured Citation
Salmon P. (2001). Effects of physical exercise on anxiety, depression, and sensiti- vity to stress: a unifying theory. Clinical
Psychology Review, 21(1), 33–61.
https://doi.org/10.1016/S0272-7358(99)00032-X
Unstructured Citation
Siripanthong B., Nazarian S., Muser D., Deo R., Santangeli P., Khanji M.Y., Cooper L.T. Jr, & Chahal C. (2020). Recognizing
Covid-19-related myocarditis: The possible pathophysiology and proposed guideline for diagno- sis and management. Heart Rhythm,
17(9), 1463–1471.
https://doi.org/10.1016/j.hrthm.2020.05.001