Постковидный синдром с позиции кардиоваскулярных нарушений

Коронавирусная инфекция стала одной из самых больших потрясений современности. Коронавирусы — это вирусы с положительной цепью РНК, чаще всего поражающие дыхательные пути. Вирус проникает в человеческие альвеолярные клетки типа II с помощью рецепторов к ангиотензинпревращающему ферменту 2 (АПФ2). SARS-CoV использует специфические факторы клеток-хозяев на протяжении всего своего инфекционного цикла. Вирус реплицируется внутри клеток, отвлекая собственные клеточные механизмы организма, и связывает вирион с рецептором АПФ2. Количество переболевших COVID-19 насчитывает более 100 млн человек. Многие выздоровевшие отмечают сохранение симптомов в течение нескольких месяцев после острого заболевания. Чаще всего пациенты жалуются на одышку, усталость, общую слабость, боли за грудиной, учащенное сердцебиение. Современные исследования наглядно продемонстрировали влияние COVID-19 на метаболические нарушения, развитие и прогрессирование сердечно-сосудистых заболеваний и летальность. В настоящее время получены достоверные данные, что при COVID-19 формируется очаг воспаления в стенке миокарда. Его патогенез полностью не выяснен. Согласно двум основным теориям, в повреждении миокарда играет важную роль АПФ2, а также гипериммунный ответ, который самостоятельно может привести к развитию миокардита. Частота и прогностическое влияние миокардита, вызванного COVID-19, неизвестны.  В данной статье был проведен анализ актуальных литературных данных об эпидемиологии, патогенезе и клинических проявлениях постковидного синдрома, в частности подострого COVID-19, в фокусе кардиоваскулярных нарушений. Поиск актуальной литературы осуществлялся на базе Web of  Science, PubMed по ключевым словам: long COVID-19, cardiovascular deseases, postacute COVID-19 syndrome, SARS-CoV-2. В анализ включались систематические обзоры, метаанализы, клинические исследования, обзоры литературы, опубликованные за последние два года.

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