Interviewer: Dr. Naidu, thank you for taking the time to do this interview today with us on
the cardiovascular complications during a SARS-CoV-2 infection.
What are some of the mechanisms currently
known which cause this virus to affect the heart?
Dr. Naidu: Thank you. It's my pleasure to be here.
This pandemic took us by storm.
I think over the past few months,
we've gained a better understanding of how it
attacks the body and how it attacks the heart.
I think, initially, similar to other coronaviruses,
we felt that this was isolated to the lung.
We do know that as it gains entry to the body,
it comes in the upper airway,
and then it gains entry to the lower airway.
We believe that it attacks by bonding to the ACE2 receptor,
so that's the angiotensin-converting enzyme 2 receptor.
That gains it entry into the lung cell,
which then allows it to replicate and then hits the rest of the body.
That being said, based on that mechanism,
one might imagine that there are other organs in the body that have the ACE2 receptor.
Interestingly, the heart does,
both in its myocardial cells,
but also in the endothelial cells of the coronary arteries.
So the heart is affected that way,
as are the kidneys,
as is the intestines,
and also all the cardiovascular system.
So all the blood vessels, arteries,
and veins have ACE2 receptors in their endothelium,
and you can imagine that that is going to impact both the vasculature,
thrombosis, as well as the interaction between the heart and the vasculature.
As you know, we call it
the cardiovascular system because the heart pumps into all these arteries,
but it's a fine balance between
how the body receives the blood and how the heart pumps the blood.
So the effects on the heart can be numerous depending on that interaction.
When it gets into the body,
it certainly has three phases of infection.
One is the early infection,
which typically involves relatively mild symptoms