COVID-19: Are we dealing with a multisystem vasculopathy in disguise of a viral infection?

Autor: Tirthankar Guha Thakurta, Ritwick Mondal, Gourav Shome, Subhash Chandra Biswas, Sudeb R. Paria, Sukanya Sarkar, Pratibha Singla, Shramana Deb, Deebya Bandyopadhyay, Durjoy Lahiri
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Middle East respiratory syndrome coronavirus
viruses
Pneumonia
Viral
ACE2
Vasculopathy
030204 cardiovascular system & hematology
medicine.disease_cause
Risk Assessment
Article
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Pandemic
medicine
Animals
Humans
Vascular Diseases
Endothelium
030212 general & internal medicine
Respiratory system
Intensive care medicine
Blood Coagulation
Pandemics
Phylogeny
Coronavirus
Hematology
SARS-CoV-2
Hypercytokinemia
business.industry
Hemodynamics
COVID-19
Thrombosis
Prognosis
medicine.disease
Pneumonia
Host-Pathogen Interactions
Blood Vessels
Cytokines
Inflammation Mediators
Coronavirus Infections
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Thrombosis and Thrombolysis
ISSN: 1573-742X
0929-5305
DOI: 10.1007/s11239-020-02210-8
Popis: After the emergence of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the last two decades, the world is facing its new challenge in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic with unprecedented global response. With the expanding domain of presentations in COVID-19 patients, the full range of manifestations is yet to unfold. The classical clinical symptoms for SARS-CoV-2 affected patients are dry cough, high fever, dyspnoea, lethal pneumonia whereas many patients have also been found to be associated with a few additional signs and clinical manifestations of isolated vasculopathy. Albeit a deep and profound knowledge has been gained on the clinical features and management of COVID-19, less clear association has been provided on SARS-CoV-2 mediated direct or indirect vasculopathy and its possible correlation with disease prognosis. The accumulative evidences suggest that novel coronavirus, apart from its primary respiratory confinement, may also invade vascular endothelial cells of several systems including cerebral, cardio-pulmonary as well as renal microvasculature, modulating multiple visceral perfusion indices. Here we analyse the phylogenetic perspective of SARS-CoV-2 along with other strains of β-coronaviridae from a standpoint of vasculopathic derangements. Based on the existing case reports, literature and open data bases, we also analyse the differential pattern of vasculopathy related changes in COVID-19 positive patients. Besides, we debate the need of modulation in clinical approach from a hemodynamical point of view, as a measure towards reducing disease transmission, morbidity and mortality in SARS-CoV-2 affected patients.
Databáze: OpenAIRE
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