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  2. Keyword: Inflammation/complications
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Editorial

Health-related Quality of Life and Long-term Outcomes after Mildly Symptomatic COVID-19: Exploring the Protocol

Lucas Borges Pereira et al. João Paulo Vilela Rodrigues Fabiana Rossi Varallo Leonardo Régis Leira Pereira

The post-COVID-19 condition has been defined by the World Health Organization as a “condition that occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, typically after three months from the onset of COVID-19, with symptoms lasting at least two months and that an alternative diagnosis can not explain.” The primary symptoms associated with this condition include fatigue, muscle and joint pain, shortness of breath, sleep difficulties, mental and neurological symptoms such as depression and anxiety, loss of smell and taste, headache, and difficulty in thinking and concentrating. , The cytopathic effect of the virus on the endothelium, along with endothelial damage as a consequence of systemic inflammation, has been associated with cardiovascular events such as myocarditis, myocardial infarction, arrhythmias, and thromboembolic events.

Various studies conducted worldwide have also found evidence of other signs and symptoms. – However, the incidence of these symptoms has shown significant variation due to the heterogeneity of the studies. This variation may be associated with factors such as the post-COVID study period, the region where the study was conducted, and the severity of the disease.

[…]

  • Arrhythmias Cardiac
  • COVID-19
  • Inflammation/complications
  • Myocardial Infarction
  • Myocarditis
  • SARS-CoV-2
  • Thromboembolism
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Creative Commons Attribution (CC BY) Creative Commons license
23/10/2023 DOI: 10.36660/abc.20230639
ABC
Editorial

Inflammation Post-Acute Myocardial Infarction: “Doctor or Monster”

Ricardo Wang et al. Fernando Carvalho Neuenschwander Bruno Ramos Nascimento

As in the short story “The Strange Case of Dr. Jekyll and Mr. Hyde ”, inflammation has a good side, which is the protection against pathogens, and helps in the process of cellular and tissue repair after an injury; on the other hand, it may also perpetuate and worsen the injury and, in the case of acute myocardial infarction (AMI), it may be the trigger of coronary occlusion. In the acute phase of AMI, the immune system is activated in the process of myocardial repair, in which the necrotic tissue is replaced by the scar tissue (fibrosis). From anatomopathological studies, we know that in the first hours after coronary occlusion, neutrophils are mainly recruited to the injury site. The local neutrophil population peaks around the third day, then a progressive decline is observed. From the fifth day, they are replaced by macrophages and both are responsible for clearing non-viable myocytes. In addition to this role, together with smooth muscle cells macrophages are responsible for angiogenesis and collagen production. The scarring process begins at the periphery of the infarcted area and extends to the nucleus, and this repair mechanism is completed in about 4–8 weeks, depending on the infarction size. ,

If we know how the inflammatory process occurs at the cellular level post-AMI, why do we continue to study inflammation? And why concentrating efforts on studies on cytokine expression? Whereas, on the one hand, the inflammatory process is necessary for the repair process, in the context of AMI, inflammation also plays an important role in complications. Such effect is observed in cardiogenic shock (causing vasodilation, vasoplegia and worsening shock), mechanical complications (papillary muscle rupture and ventricular free wall, and interventricular communication), in ventricular remodeling (fibrotic expansion and replacement of the affected wall) and, in the long run, it has been related to new cardiovascular events. Cytokines are molecules that mediate immune and inflammatory reactions and are responsible for activating inappropriate pathways or exaggerated responses (hypersensitivity). Therefore, understanding its kinetics can help to clarify the pathways associated with favorable outcomes and the pathways that, when activated, may lead to an increase in unfavorable events and have the potential to be the target of future therapeutic approaches.

[…]

  • B-Lymphocytes
  • Cytokines
  • Inflammation/complications
  • Myocardial Infarction
  • Shock, Cardiogenic
  • Vasoplegia
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Creative Commons Attribution (CC BY) Creative Commons license
18/01/2021 DOI: 10.36660/abc.20201250 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Pereira LB, Rodrigues JPV, Varallo FR, Pereira LRL. Health-related Quality of Life and Long-term Outcomes after Mildly Symptomatic COVID-19: Exploring the Protocol. Arquivos Brasileiros de Cardiologia 2023;120(9):e20230639.

Electronic Document Format (ABNT)

Pereira, Lucas Borges; Rodrigues, João Paulo Vilela; Varallo, Fabiana Rossi; Pereira, Leonardo Régis Leira. Health-related Quality of Life and Long-term Outcomes after Mildly Symptomatic COVID-19: Exploring the Protocol. Arquivos Brasileiros de Cardiologia, v. 120, n. 9, e20230639, Oct. 2023.

Electronic Document Format (APA)

Pereira, L. B., Rodrigues, J. P. V., Varallo, F. R., & Pereira, L. R. L. (2023). Health-related Quality of Life and Long-term Outcomes after Mildly Symptomatic COVID-19: Exploring the Protocol. Arquivos Brasileiros de Cardiologia, 120(9), e20230639.

Electronic Document Format (ISO)

Pereira, Lucas Borges and Rodrigues, João Paulo Vilela and Varallo, Fabiana Rossi and Pereira, Leonardo Régis Leira. Health-related Quality of Life and Long-term Outcomes after Mildly Symptomatic COVID-19: Exploring the Protocol. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 9, [cited 2026-10-14], e20230639. Available from: <https://journals.cardiol.br/en/article/health-related-quality-of-life-and-long-term-outcomes-after-mildly-symptomatic-covid-19-exploring-the-protocol/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Wang R, Neuenschwander FC, Nascimento BR. Inflammation Post-Acute Myocardial Infarction: “Doctor or Monster”. Arquivos Brasileiros de Cardiologia 2021;115(6):1-2.

Electronic Document Format (ABNT)

Wang, Ricardo; Neuenschwander, Fernando Carvalho; Nascimento, Bruno Ramos. Inflammation Post-Acute Myocardial Infarction: “Doctor or Monster”. Arquivos Brasileiros de Cardiologia, v. 115, n. 6, p. 1-2, Jan. 2021.

Electronic Document Format (APA)

Wang, R., Neuenschwander, F. C., & Nascimento, B. R. (2021). Inflammation Post-Acute Myocardial Infarction: “Doctor or Monster”. Arquivos Brasileiros de Cardiologia, 115(6), 1-2.

Electronic Document Format (ISO)

Wang, Ricardo and Neuenschwander, Fernando Carvalho and Nascimento, Bruno Ramos. Inflammation Post-Acute Myocardial Infarction: “Doctor or Monster”. Arquivos Brasileiros de Cardiologia [online]. 2021, vol. 115, n. 6, [cited 2026-10-14], pp. 1-2. Available from: <https://journals.cardiol.br/en/article/inflammation-post-acute-myocardial-infarction-doctor-or-monster/>. ISSN 0066-782X

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