Understanding the heart-brain axis response in COVID-19 patients: A suggestive perspective for therapeutic development

Pharmacol Res. 2021 Jun:168:105581. doi: 10.1016/j.phrs.2021.105581. Epub 2021 Mar 26.

Abstract

In-depth characterization of heart-brain communication in critically ill patients with severe acute respiratory failure is attracting significant interest in the COronaVIrus Disease 19 (COVID-19) pandemic era during intensive care unit (ICU) stay and after ICU or hospital discharge. Emerging research has provided new insights into pathogenic role of the deregulation of the heart-brain axis (HBA), a bidirectional flow of information, in leading to severe multiorgan disease syndrome (MODS) in patients with confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Noteworthy, HBA dysfunction may worsen the outcome of the COVID-19 patients. In this review, we discuss the critical role HBA plays in both promoting and limiting MODS in COVID-19. We also highlight the role of HBA as new target for novel therapeutic strategies in COVID-19 in order to open new translational frontiers of care. This is a translational perspective from the Italian Society of Cardiovascular Researches.

Keywords: COVID-19; Heart-brain axis; Multiorgan disease syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Antiviral Agents / administration & dosage
  • Brain / drug effects*
  • Brain / immunology
  • Brain / metabolism
  • Brain Diseases / immunology
  • Brain Diseases / metabolism
  • Brain Diseases / therapy*
  • COVID-19 / immunology
  • COVID-19 / metabolism
  • COVID-19 / therapy*
  • Critical Care / methods
  • Critical Illness / therapy
  • Dietary Supplements
  • Functional Food
  • Heart / drug effects*
  • Heart Diseases / immunology
  • Heart Diseases / metabolism
  • Heart Diseases / therapy*
  • Humans
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism
  • Microvessels / drug effects
  • Microvessels / immunology
  • Microvessels / metabolism
  • Multiple Organ Failure / immunology
  • Multiple Organ Failure / metabolism
  • Multiple Organ Failure / therapy
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / metabolism

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Inflammation Mediators