Kounis syndrome in the era of COVID-19: pathophysiology, clinical challenges, and therapeutic approaches

Kounis syndrome, first described in 1991, refers to allergic or hypersensitive reactions that result in acute coronary syndrome (ACS). In addition to SARS-CoV-2, this disease has enhanced our comprehension of viral infections, inflammatory reactions, and cardiovascular repercussions. The COVID-19 pandemic has exposed the occurrence of cardiac damage, arrhythmias, and thrombotic events that are associated to the SARS-CoV-2 virus, thereby making the understanding of their development more complex. This research explores the complex correlation between Kounis syndrome and COVID-19, encompassing the phenomena of cytokine storms and endothelial dysfunction. Diagnosing Kounis syndrome in the context of COVID-19 presents challenges, nevertheless, it is imperative to distinguish it from other cardiovascular disorders. The identification of risk factors and predisposing situations that can exacerbate Kounis syndrome in COVID-19 patients is highlighted, with a particular focus on patient assessment. The care of Kounis syndrome in COVID-19 necessitates a multidisciplinary strategy that involves collaboration among cardiologists, allergists, and other specialists. Possible therapies encompass epinephrine, antihistamines, corticosteroids, cardiovascular interventions, as well as long-term surveillance and measures to reduce risk. Additional investigation should include epidemiological enquiries, experimental frameworks, and advancements in diagnostic and therapeutic approaches. Comprehending the connection between viral infections and coronary syndromes caused by allergies is crucial for clinical practice and the well-being of patients. This review explores the neurobiological similarities and clinical implications of Kounis syndrome and COVID-19, aiming to enhance comprehension and treatment of this intricate clinical scenario.