The pandemic of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has become a global challenge to public health. While its typical clinical manifestations are respiratory disorders, emerging evidence of cardiovascular complications indicates the adverse interaction between SARS-CoV-2 infection and cardiovascular outcomes. Given that viral infection has emerged as an additional risk factor for atherosclerosis, in this paper, we attempt to clarify the susceptibility to new-onset atherosclerosis in individuals infected with SARS-CoV-2. Mechanistically, serving as functional receptors for SARS-CoV-2, angiotensin-converting enzyme 2 (ACE2) mediates SARS-CoV-2 infection of endothelial cells (ECs) directly, leading to endothelial dysfunction and dysregulation of the renin-angiotensin system (RAS). In addition, high expression of CD147, an alternative receptor, and activation of the NLRP3 inflammasome may also contribute to atherosclerosis in the context of COVID-19. More importantly, SARS-CoV-2 attacks the immune system, which results in excessive inflammation and perpetuates a vicious cycle of deteriorated endothelial dysfunction that further promotes inflammation. The alterations in the blood lipid profile induced by COVID-19 should not be ignored in assessing the predisposition toward atherosclerosis in victims of COVID-19. A better understanding of the underlying mechanisms of SARS-CoV-2 infection and the long-term monitoring of inflammatory factors and endothelial function should be considered in the follow-up of patients who have recovered from COVID-19 for early detection and prevention of atherosclerosis.
【저자키워드】 COVID-19, SARS-CoV-2, Inflammation, angiotensin-converting enzyme 2, Endothelial dysfunction, Atherosclerosis, 【초록키워드】 coronavirus disease, public health, viral infection, ACE2, pandemic, SARS-COV-2 infection, susceptibility, immune system, risk factor, RAS, NLRP3 inflammasome, CD147, renin-angiotensin system, outcomes, Patient, Follow-up, receptor, expression, mechanism, Endothelial cell, Evidence, Interaction, endothelial function, dysregulation, blood lipid, clinical manifestation, cardiovascular complication, Activation, alteration, individual, excessive inflammation, respiratory disorders, predisposition, while, vicious cycle, attack, Inflammatory factor, caused, addition, indicate, contribute, promote, functional receptor, infected with SARS-CoV-2, 【제목키워드】 Vigilance,