The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications.

The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications. Circ Res. 2020 Jun 26;: Authors: McFadyen JD, Stevens H, Peter K Abstract The recent emergence of SARS-CoV-2 and the ensuing global pandemic has presented a health emergency of unprecedented magnitude. Recent clinical data has highlighted that COVID-19 is associated with a significant risk of thrombotic complications ranging from microvascular thrombosis, venous thromboembolic disease and stroke. Importantly, thrombotic complications are markers of severe COVID-19 and are associated with multi-organ failure and increased mortality. The evidence to date supports the concept that the thrombotic manifestations of severe COVID-19 is due to the ability of SARS-CoV-2 to invade endo¬thelial cells via angiotensin-converting enzyme 2 (ACE2), which is expressed on the endothelial cell surface. However, in patients with COVID-19 the subsequent endothelial inflammation, complement activation, thrombin generation, platelet and leukocyte recruitment, and the initiation of innate and adaptive immune responses culminate in immunothrombosis, ultimately causing (micro)thrombotic compli¬cations such as deep vein thrombosis, pulmonary embolism and stroke. Accordingly, the activation of coagulation (e.g. as measured with plasma D-dimer) and thrombocytopenia have emerged as prognostic markers in COVID-19. Given thrombotic complications are central determinants of the ...
Source: Circulation Research - Category: Cardiology Authors: Tags: Circ Res Source Type: research