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Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction

The coronavirus pandemic has reportedly infected over 31.5 million individuals and caused over 970,000 deaths worldwide (as of 22nd Sept 2020). This novel coronavirus, officially named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although primarily causes significant respiratory dis...

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Autores principales: Roberts, Kirsty A., Colley, Liam, Agbaedeng, Thomas A., Ellison-Hughes, Georgina M., Ross, Mark D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649150/
https://www.ncbi.nlm.nih.gov/pubmed/33195487
http://dx.doi.org/10.3389/fcvm.2020.598400
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author Roberts, Kirsty A.
Colley, Liam
Agbaedeng, Thomas A.
Ellison-Hughes, Georgina M.
Ross, Mark D.
author_facet Roberts, Kirsty A.
Colley, Liam
Agbaedeng, Thomas A.
Ellison-Hughes, Georgina M.
Ross, Mark D.
author_sort Roberts, Kirsty A.
collection PubMed
description The coronavirus pandemic has reportedly infected over 31.5 million individuals and caused over 970,000 deaths worldwide (as of 22nd Sept 2020). This novel coronavirus, officially named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although primarily causes significant respiratory distress, can have significant deleterious effects on the cardiovascular system. Severe cases of the virus frequently result in respiratory distress requiring mechanical ventilation, often seen, but not confined to, individuals with pre-existing hypertension and cardiovascular disease, potentially due to the fact that the virus can enter the circulation via the lung alveoli. Here the virus can directly infect vascular tissues, via TMPRSS2 spike glycoprotein priming, thereby facilitating ACE-2-mediated viral entry. Clinical manifestations, such as vasculitis, have been detected in a number of vascular beds (e.g., lungs, heart, and kidneys), with thromboembolism being observed in patients suffering from severe coronavirus disease (COVID-19), suggesting the virus perturbs the vasculature, leading to vascular dysfunction. Activation of endothelial cells via the immune-mediated inflammatory response and viral infection of either endothelial cells or cells involved in endothelial homeostasis, are some of the multifaceted mechanisms potentially involved in the pathogenesis of vascular dysfunction within COVID-19 patients. In this review, we examine the evidence of vascular manifestations of SARS-CoV-2, the potential mechanism(s) of entry into vascular tissue and the contribution of endothelial cell dysfunction and cellular crosstalk in this vascular tropism of SARS-CoV-2. Moreover, we discuss the current evidence on hypercoagulability and how it relates to increased microvascular thromboembolic complications in COVID-19.
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spelling pubmed-76491502020-11-13 Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction Roberts, Kirsty A. Colley, Liam Agbaedeng, Thomas A. Ellison-Hughes, Georgina M. Ross, Mark D. Front Cardiovasc Med Cardiovascular Medicine The coronavirus pandemic has reportedly infected over 31.5 million individuals and caused over 970,000 deaths worldwide (as of 22nd Sept 2020). This novel coronavirus, officially named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although primarily causes significant respiratory distress, can have significant deleterious effects on the cardiovascular system. Severe cases of the virus frequently result in respiratory distress requiring mechanical ventilation, often seen, but not confined to, individuals with pre-existing hypertension and cardiovascular disease, potentially due to the fact that the virus can enter the circulation via the lung alveoli. Here the virus can directly infect vascular tissues, via TMPRSS2 spike glycoprotein priming, thereby facilitating ACE-2-mediated viral entry. Clinical manifestations, such as vasculitis, have been detected in a number of vascular beds (e.g., lungs, heart, and kidneys), with thromboembolism being observed in patients suffering from severe coronavirus disease (COVID-19), suggesting the virus perturbs the vasculature, leading to vascular dysfunction. Activation of endothelial cells via the immune-mediated inflammatory response and viral infection of either endothelial cells or cells involved in endothelial homeostasis, are some of the multifaceted mechanisms potentially involved in the pathogenesis of vascular dysfunction within COVID-19 patients. In this review, we examine the evidence of vascular manifestations of SARS-CoV-2, the potential mechanism(s) of entry into vascular tissue and the contribution of endothelial cell dysfunction and cellular crosstalk in this vascular tropism of SARS-CoV-2. Moreover, we discuss the current evidence on hypercoagulability and how it relates to increased microvascular thromboembolic complications in COVID-19. Frontiers Media S.A. 2020-10-26 /pmc/articles/PMC7649150/ /pubmed/33195487 http://dx.doi.org/10.3389/fcvm.2020.598400 Text en Copyright © 2020 Roberts, Colley, Agbaedeng, Ellison-Hughes and Ross. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Roberts, Kirsty A.
Colley, Liam
Agbaedeng, Thomas A.
Ellison-Hughes, Georgina M.
Ross, Mark D.
Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title_full Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title_fullStr Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title_full_unstemmed Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title_short Vascular Manifestations of COVID-19 – Thromboembolism and Microvascular Dysfunction
title_sort vascular manifestations of covid-19 – thromboembolism and microvascular dysfunction
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649150/
https://www.ncbi.nlm.nih.gov/pubmed/33195487
http://dx.doi.org/10.3389/fcvm.2020.598400
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