Collection: CME Articles

Review Articles

Acute and Chronic Cardiovascular Manifestations of COVID-19: Role for Endotheliopathy



SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), is associated with a bewildering array of cardiovascular manifestations, including myocardial infarction and stroke, myocarditis and heart failure, atrial and ventricular arrhythmias, venous thromboembolism, and microvascular disease. Accumulating evidence indicates that a profound disturbance of endothelial homeostasis contributes to these conditions. Furthermore, the pulmonary infiltration and edema, and later pulmonary fibrosis, in patients with COVID-19 is promoted by endothelial alterations including the expression of endothelial adhesion molecules and chemokines, increased intercellular permeability, and endothelial-to-mesenchyme transitions. The cognitive disturbance occurring in this disease may also be due in part to an impairment of the blood-brain barrier. Venous thrombosis and pulmonary thromboembolism are most likely associated with an endothelial defect caused by circulating inflammatory cytokines and/or direct endothelial invasion by the virus. Endothelial-targeted therapies such as statins, nitric oxide donors, and antioxidants may be useful therapeutic adjuncts in COVID-19 by restoring endothelial homeostasis.


SARS-CoV-2endotheliumdeep venous thrombosispulmonary embolismmyocardial infarctioncerebrovascular attackdementiamyocarditisnitric oxide
  • Year: 2021
  • Volume: 17 Issue: 5
  • Page/Article: 53-62
  • DOI: 10.14797/mdcvj.1044
  • Submitted on 23 Sep 2021
  • Accepted on 13 Oct 2021
  • Published on 15 Dec 2021
  • Peer Reviewed