4.4 Article

Cardiovascular, hematological and neurosensory impact of COVID-19 and variants

Journal

Publisher

VERDUCI PUBLISHER
DOI: 10.26355/eurrev_202104_25747

Keywords

COVID-19 pandemic; Cardiovascular impact; Hematological impact; Neurosensory impact; Cytokine storm; Disseminated intravascular coagulation; Acro-ischemic syndrome; Anosmia; Dysgeusia; SARS-COV-2 variants

Funding

  1. European Union COST Action, Cooperation in Science Technology [CA16122]

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This article reviews the clinical experience with COVID-19 patients regarding the impact on cardiovascular, hematological, and neurological systems. It emphasizes the importance of early symptoms for diagnosis and treatment. COVID-19 is highlighted as a prothrombotic disease with high global lethality.
OBJECTIVE: The purpose of this article was to review our clinical experience with COVID-19 patients observed in the Cardiovascular Division of Pompidou Hospital (University of Paris, France) and the Department of Neurology of the Eastern Piedmont University (Novara, Italy), related to the impact on the cardiovascular, hematological, and neurologic systems and sense organs. PATIENTS AND METHODS: We sought to characterize cardiovascular, hematological, and neurosensory manifestations in patients with COVID-19 and variants. Special attention was given to initial signs and symptoms to facilitate early diagnosis and therapy. Indications of ECMO (extracorporeal membrane oxygenation) for cardiorespiratory support were evaluated. RESULTS: Preliminary neurosensorial symptoms, such as anosmia and dysgeusia, are useful for diagnosis, patient isolation, and treatment. Early angiohematological acro-ischemic syndrome includes hand and foot cyanosis, Raynaud digital ischemia phenomenon, skin bullae, and dry gangrene. This was associated with neoangiogenesis, vasculitis, and vessel thrombosis related to immune dysregulation, resulting from cytokine storm syndrome. The most dangerous complication is disseminated intravascular coagulation, with mortality risks for both children and adults. CONCLUSIONS: COVID-19 is a prothrombotic disease with unique global lethality. A strong inflammatory response to viral infection severely affects cardiovascular and neurological systems, as well as respiratory, immune, and hematological systems. Rapid identification of acro-ischemic syndrome permits the treatment of disseminated intravascular coagulation complications. Early sensorial symptoms, such as gustatory and olfactory loss, are useful for COVID-19 diagnosis. New variants of SARS-CoV-2 are emerging, principally from United Kingdom, South Africa, and Brazil. These variants seem to spread more easily and quickly, which may lead to more cases of COVID.

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