1. Implications of microvascular dysfunction and nitric oxide mediated inflammation in severe COVID-19 infection
- Author
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Jani, Vinay P, Munoz, Carlos J, Govender, Krianthan, Williams, Alexander T, and Cabrales, Pedro
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Cardiovascular ,Rare Diseases ,2.1 Biological and endogenous factors ,Aetiology ,Good Health and Well Being ,COVID-19 ,Humans ,Inflammation ,Nitric Oxide ,Pandemics ,Microcirculation ,Endothelial glycocalyx ,Cardiovascular disease ,Nitric oxide ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
Infection with COVID-19 has resulted in over 276,000 deaths in the United States and over 1.5 million deaths globally, with upwards of 15% of patients requiring hospitalization. Severe COVID-19 infection is, in essence, a microvascular disease. This contention has been emphasized throughout the course of the pandemic, particularly due to the clinical manifestation of severe infection. In fact, it has been hypothesized and shown in particular instances that microvascular function is a significant prognosticator for morbidity and mortality. Initially thought to be isolated to the pulmonary system and resulting in ARDS, patients with COVID-19 have been observed to have acute cardiac, renal, and thrombolytic complications. Therefore, severe COVID-19 is a vascular disease that has systemic implications. The objective of this review is to provide a mechanistic background for the microvascular nature of severe COVID-19 infection, with a particular emphasis on dysfunction of the endothelial glycocalyx and nitric oxide mediated pathogenesis.
- Published
- 2022