Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic that has affected the lives of billions of individuals. Extensive studies have revealed that SARS-CoV-2 shares many biological features with SARS-CoV, the zoonotic virus that caused the 2002 outbreak of severe acute respiratory syndrome, including the system of cell entry, which is triggered by binding of the viral spike protein to angiotensin-converting enzyme 2. Clinical studies have also reported an association between COVID-19 and cardiovascular disease. Pre-existing cardiovascular disease seems to be linked with worse outcomes and increased risk of death in patients with COVID-19, whereas COVID-19 itself can also induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism. Potential drug-disease interactions affecting patients with COVID-19 and comorbid cardiovascular diseases are also becoming a serious concern. In this Review, we summarize the current understanding of COVID-19 from basic mechanisms to clinical perspectives, focusing on the interaction between COVID-19 and the cardiovascular system. By combining our knowledge of the biological features of the virus with clinical findings, we can improve our understanding of the potential mechanisms underlying COVID-19, paving the way towards the development of preventative and therapeutic solutions.

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COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives.

Physicians must consider case-fatality rates for recurrent venous thromboembolism (VTE) and major bleeding when weighing the benefits and harms of new anticoagulant strategies for VTE. This systema...

Systematic Review: Case-Fatality Rates of Recurrent Venous Thromboembolism and Major Bleeding Events Among Patients Treated for Venous Thromboembolism

The core pathology of coronavirus disease 2019 (COVID-19) is infection of airway cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in excessive inflammation and respiratory disease, with cytokine storm and acute respiratory distress syndrome implicated in the most severe cases. Thrombotic complications are a major cause of morbidity and mortality in patients with COVID-19. Patients with pre-existing cardiovascular disease and/or traditional cardiovascular risk factors, including obesity, diabetes mellitus, hypertension and advanced age, are at the highest risk of death from COVID-19. In this Review, we summarize new lines of evidence that point to both platelet and endothelial dysfunction as essential components of COVID-19 pathology and describe the mechanisms that might account for the contribution of cardiovascular risk factors to the most severe outcomes in COVID-19. We highlight the distinct contributions of coagulopathy, thrombocytopathy and endotheliopathy to the pathogenesis of COVID-19 and discuss potential therapeutic strategies in the management of patients with COVD-19. Harnessing the expertise of the biomedical and clinical communities is imperative to expand the available therapeutics beyond anticoagulants and to target both thrombocytopathy and endotheliopathy. Only with such collaborative efforts can we better prepare for further waves and for future coronavirus-related pandemics.

/pdf/thrombocytopathy-and-endotheliopathy-crucial-contributors-to-mkgz81igr9.pdf

Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation.

Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections.

Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Acute limb ischemia in patients with COVID-19 pneumonia.

Objectives A retrospective study to evaluate the treatment, long term follow-up and factors affecting revascularization results particularly in regard to clinical presentation and prosthetic materials used after 20 years of experience. Materials and methods Between 1974 and September 1995 there were 67 popliteal aneurysms in 58 patients. Three patients underwent a primary amputation because of irreversible ischaemia and 3 patients a surgical sympathectomy. Operative repair was performed in 61 cases: as an emergency in 9 (14.7%) limbs and as an elective procedure in 52 (85.3%) limbs. Graft replacement was performed employing polytetrafluoroethylene (PTFE) grafts in 34 (55.7%) cases 13 of which with Ringed PTFE, autogenous saphenous vein in 10 (16.4%) cases and Dacron in 17 (27.9%). Results The cumulative primary patency (CP) and limb salvage rate (LS) at 10 years were 75.1% and 83.3% respectively. We divided the patients into two groups: asymptomatic (Group I) and symptomatic with limb threatening ischemia (Group II). At 10 years the CP in Group I and II were 78.2% vs 67.2% respectively (p Conclusions We conclude that elective repair is indicated in all patients with popliteal aneurysm > or = 2 cm to avoid a critical ischemia with poorer results in terms of CP and LS. In the last 3 years our technique of choice is the exclusion of the aneurysm with a short PTFE bypass with good long-term of CP and LS rates.

Raffaello Bellosta

Papers

Acute limb ischemia in patients with COVID-19 pneumonia.

Surgical treatment of popliteal artery aneurysm. A 20 year experience.

Predictors and outcomes of acute kidney injury after thoracic aortic endograft repair

Routine shunting is a safe and reliable method of cerebral protection during carotid endarterectomy.

Results from the Multicenter Study on Aortoenteric Fistulization After Stent Grafting of the Abdominal Aorta (MAEFISTO)