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Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation.
- Source :
-
Nature reviews. Cardiology [Nat Rev Cardiol] 2021 Mar; Vol. 18 (3), pp. 194-209. Date of Electronic Publication: 2020 Nov 19. - Publication Year :
- 2021
-
Abstract
- The core pathology of coronavirus disease 2019 (COVID-19) is infection of airway cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in excessive inflammation and respiratory disease, with cytokine storm and acute respiratory distress syndrome implicated in the most severe cases. Thrombotic complications are a major cause of morbidity and mortality in patients with COVID-19. Patients with pre-existing cardiovascular disease and/or traditional cardiovascular risk factors, including obesity, diabetes mellitus, hypertension and advanced age, are at the highest risk of death from COVID-19. In this Review, we summarize new lines of evidence that point to both platelet and endothelial dysfunction as essential components of COVID-19 pathology and describe the mechanisms that might account for the contribution of cardiovascular risk factors to the most severe outcomes in COVID-19. We highlight the distinct contributions of coagulopathy, thrombocytopathy and endotheliopathy to the pathogenesis of COVID-19 and discuss potential therapeutic strategies in the management of patients with COVD-19. Harnessing the expertise of the biomedical and clinical communities is imperative to expand the available therapeutics beyond anticoagulants and to target both thrombocytopathy and endotheliopathy. Only with such collaborative efforts can we better prepare for further waves and for future coronavirus-related pandemics.
- Subjects :
- Administration, Inhalation
Anticoagulants therapeutic use
Blood Coagulation Disorders drug therapy
Blood Coagulation Disorders etiology
Blood Coagulation Disorders physiopathology
Blood Platelet Disorders drug therapy
Blood Platelet Disorders etiology
Blood Platelet Disorders physiopathology
COVID-19 complications
COVID-19 physiopathology
Endothelium-Dependent Relaxing Factors therapeutic use
Epoprostenol therapeutic use
Heart Disease Risk Factors
Humans
Iloprost therapeutic use
Inflammation etiology
Inflammation physiopathology
Nitric Oxide therapeutic use
Platelet Aggregation Inhibitors therapeutic use
SARS-CoV-2
Systemic Inflammatory Response Syndrome blood
Systemic Inflammatory Response Syndrome drug therapy
Systemic Inflammatory Response Syndrome physiopathology
Thrombosis etiology
Thrombosis immunology
Thrombotic Microangiopathies blood
Thrombotic Microangiopathies drug therapy
Thrombotic Microangiopathies etiology
Thrombotic Microangiopathies physiopathology
Vascular Diseases blood
Vascular Diseases drug therapy
Vascular Diseases etiology
Vascular Diseases physiopathology
Vasodilator Agents therapeutic use
Venous Thromboembolism blood
Venous Thromboembolism drug therapy
Venous Thromboembolism etiology
Venous Thromboembolism physiopathology
COVID-19 Drug Treatment
Blood Coagulation Disorders blood
Blood Platelet Disorders blood
COVID-19 blood
Endothelium, Vascular physiopathology
Inflammation blood
Thrombosis blood
Subjects
Details
- Language :
- English
- ISSN :
- 1759-5010
- Volume :
- 18
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nature reviews. Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 33214651
- Full Text :
- https://doi.org/10.1038/s41569-020-00469-1