[PERSPECTIVES] Endothelialitis, Microischemia, and Intussusceptive Angiogenesis in COVID-19

COVID-19 has been associated with a range of illness severity—from minimal symptoms to life-threatening multisystem organ failure. The severe forms of COVID-19 appear to be associated with an angiocentric or vascular phase of the disease. In studying autopsy patients succumbing to COVID-19, we found alveolar capillary microthrombi were 9 times more common in COVID-19 than in comparable patients with influenza. Corrosion casting of the COVID-19 microcirculation has revealed microvascular distortion, enhanced bronchial circulation, and striking increases in intussusceptive angiogenesis. In patients with severe COVID-19, endothelial cells commonly demonstrate significant ultrastructural injury. High-resolution imaging suggests that microcirculation perturbations are linked to ischemic changes in microanatomic compartments of the lung (secondary lobules). NanoString profiling of these regions has confirmed a transcriptional signature compatible with microischemia. We conclude that irreversible tissue ischemia provides an explanation for the cystic and fibrotic changes associated with long-haul COVID-19 symptoms.

Source: Cold Spring Harbor perspectives in medicine - October 3, 2022 Category: Research Authors: Mentzer, S. J., Ackermann, M., Jonigk, D. Tags: Angiogenesis PERSPECTIVES Source Type: research