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Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story
The pathophysiology of some non-communicable diseases (NCDs) such as hypertension, cardiovascular disease (CVD), diabetes, and cancer includes an alteration of the endothelial function. COVID-19 is a pulmonary and vascular disease with a negative impact on patients whose damaged endothelium is parti...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831543/ https://www.ncbi.nlm.nih.gov/pubmed/35155636 http://dx.doi.org/10.3389/fcvm.2022.821193 |
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author | Bisceglia, Irma Canale, Maria Laura Gallucci, Giuseppina Turazza, Fabio Maria Lestuzzi, Chiara Parrini, Iris Russo, Giulia Maurea, Nicola Quagliariello, Vincenzo Oliva, Stefano Di Fusco, Stefania Angela Lucà, Fabiana Tarantini, Luigi Trambaiolo, Paolo Moreo, Antonella Geraci, Giovanna Gabrielli, Domenico Gulizia, Michele Massimo Oliva, Fabrizio Colivicchi, Furio |
author_facet | Bisceglia, Irma Canale, Maria Laura Gallucci, Giuseppina Turazza, Fabio Maria Lestuzzi, Chiara Parrini, Iris Russo, Giulia Maurea, Nicola Quagliariello, Vincenzo Oliva, Stefano Di Fusco, Stefania Angela Lucà, Fabiana Tarantini, Luigi Trambaiolo, Paolo Moreo, Antonella Geraci, Giovanna Gabrielli, Domenico Gulizia, Michele Massimo Oliva, Fabrizio Colivicchi, Furio |
author_sort | Bisceglia, Irma |
collection | PubMed |
description | The pathophysiology of some non-communicable diseases (NCDs) such as hypertension, cardiovascular disease (CVD), diabetes, and cancer includes an alteration of the endothelial function. COVID-19 is a pulmonary and vascular disease with a negative impact on patients whose damaged endothelium is particularly vulnerable. The peculiar SARS-CoV-2-induced “endothelitis” triggers an intriguing immune-thrombosis that affects both the venous and arterial vascular beds. An increased liability for infection and an increased likelihood of a worse outcome have been observed during the pandemic in patients with active cancer and in cancer survivors. “Overlapping commonalities” between COVID-19 and Cardio-Oncology have been described that include shared phenotypes of cardiovascular toxicities such as left ventricular dysfunction, ischemic syndromes, conduction disturbances, myocarditis, pericarditis and right ventricular failure; shared pathophysiologic mechanisms such as inflammation, release of cytokines, the renin-angiotensin-aldosterone-pathway, coagulation abnormalities, microthrombosis and endothelial dysfunction. For these features and for the catalyst role of NCDs (mainly CVD and cancer), we should refer to COVID-19 as a “syndemic.” Another challenging issue is the persistence of the symptoms, the so-called “long COVID” whose pathogenesis is still uncertain: it may be due to persistent multi-organ viral attacks or to an abnormal immune response. An intensive vaccination campaign is the most successful pharmacological weapon against SARS-CoV-2, but the increasing number of variants has reduced the efficacy of the vaccines in controlling SARS-CoV-2 infections. After a year of vaccinations we have also learned more about efficacy and side-effects of COVID-19 vaccines. An important byproduct of the COVID-19 pandemic has been the rapid expansion of telemedicine platforms across different care settings; this new modality of monitoring cancer patients may be useful even in a post pandemic era. In this paper we analyze the problems that the cardio-oncologists are facing in a pandemic scenario modified by the extensive vaccination campaign and add actionable recommendations derived from the ongoing studies and from the syndemic nature of the infection. |
format | Online Article Text |
id | pubmed-8831543 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-88315432022-02-12 Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story Bisceglia, Irma Canale, Maria Laura Gallucci, Giuseppina Turazza, Fabio Maria Lestuzzi, Chiara Parrini, Iris Russo, Giulia Maurea, Nicola Quagliariello, Vincenzo Oliva, Stefano Di Fusco, Stefania Angela Lucà, Fabiana Tarantini, Luigi Trambaiolo, Paolo Moreo, Antonella Geraci, Giovanna Gabrielli, Domenico Gulizia, Michele Massimo Oliva, Fabrizio Colivicchi, Furio Front Cardiovasc Med Cardiovascular Medicine The pathophysiology of some non-communicable diseases (NCDs) such as hypertension, cardiovascular disease (CVD), diabetes, and cancer includes an alteration of the endothelial function. COVID-19 is a pulmonary and vascular disease with a negative impact on patients whose damaged endothelium is particularly vulnerable. The peculiar SARS-CoV-2-induced “endothelitis” triggers an intriguing immune-thrombosis that affects both the venous and arterial vascular beds. An increased liability for infection and an increased likelihood of a worse outcome have been observed during the pandemic in patients with active cancer and in cancer survivors. “Overlapping commonalities” between COVID-19 and Cardio-Oncology have been described that include shared phenotypes of cardiovascular toxicities such as left ventricular dysfunction, ischemic syndromes, conduction disturbances, myocarditis, pericarditis and right ventricular failure; shared pathophysiologic mechanisms such as inflammation, release of cytokines, the renin-angiotensin-aldosterone-pathway, coagulation abnormalities, microthrombosis and endothelial dysfunction. For these features and for the catalyst role of NCDs (mainly CVD and cancer), we should refer to COVID-19 as a “syndemic.” Another challenging issue is the persistence of the symptoms, the so-called “long COVID” whose pathogenesis is still uncertain: it may be due to persistent multi-organ viral attacks or to an abnormal immune response. An intensive vaccination campaign is the most successful pharmacological weapon against SARS-CoV-2, but the increasing number of variants has reduced the efficacy of the vaccines in controlling SARS-CoV-2 infections. After a year of vaccinations we have also learned more about efficacy and side-effects of COVID-19 vaccines. An important byproduct of the COVID-19 pandemic has been the rapid expansion of telemedicine platforms across different care settings; this new modality of monitoring cancer patients may be useful even in a post pandemic era. In this paper we analyze the problems that the cardio-oncologists are facing in a pandemic scenario modified by the extensive vaccination campaign and add actionable recommendations derived from the ongoing studies and from the syndemic nature of the infection. Frontiers Media S.A. 2022-01-28 /pmc/articles/PMC8831543/ /pubmed/35155636 http://dx.doi.org/10.3389/fcvm.2022.821193 Text en Copyright © 2022 Bisceglia, Canale, Gallucci, Turazza, Lestuzzi, Parrini, Russo, Maurea, Quagliariello, Oliva, Di Fusco, Lucà, Tarantini, Trambaiolo, Moreo, Geraci, Gabrielli, Gulizia, Oliva and Colivicchi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Bisceglia, Irma Canale, Maria Laura Gallucci, Giuseppina Turazza, Fabio Maria Lestuzzi, Chiara Parrini, Iris Russo, Giulia Maurea, Nicola Quagliariello, Vincenzo Oliva, Stefano Di Fusco, Stefania Angela Lucà, Fabiana Tarantini, Luigi Trambaiolo, Paolo Moreo, Antonella Geraci, Giovanna Gabrielli, Domenico Gulizia, Michele Massimo Oliva, Fabrizio Colivicchi, Furio Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title | Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title_full | Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title_fullStr | Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title_full_unstemmed | Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title_short | Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story |
title_sort | cardio-oncology in the covid era (co & co): the never ending story |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831543/ https://www.ncbi.nlm.nih.gov/pubmed/35155636 http://dx.doi.org/10.3389/fcvm.2022.821193 |
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