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. 2020 Oct 27;142(17):1609-1611.
doi: 10.1161/CIRCULATIONAHA.120.050354. Epub 2020 Sep 2.

Severe COVID-19 Is a Microvascular Disease

Charles J Lowenstein  1 , Scott D Solomon  1
Affiliations

Severe COVID-19 Is a Microvascular Disease

Charles J Lowenstein et al. Circulation. .
No abstract available

Keywords: P-selectin; coronavirus; exocytosis; thrombosis; von Willebrand Factor.

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Figures

Figure.
Figure.
Endothelial exocytosis in coronavirus disease 2019 (COVID-19). We propose that the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) injures endothelial cells. Endothelial cells respond to viral injury by exocytosis, mobilizing granules that release von Willebrand factor and P-selectin. P-selectin plays a dual role, accelerating thrombosis by binding to platelets, and mediating vascular inflammation by interacting with leukocytes.
See this image and copyright information in PMC

References

    1. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers D, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res. 2020;191:148–150. doi: 10.1016/j.thromres.2020.04.041 - PMC - PubMed
    1. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, Mehra MR, Schuepbach RA, Ruschitzka F, Moch H. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395:1417–1418. doi: 10.1016/S0140-6736(20)30937-5 - PMC - PubMed
    1. Escher R, Breakey N, Lämmle B. Severe COVID-19 infection associated with endothelial activation. Thromb Res. 2020;190:62 doi: 10.1016/j.thromres.2020.04.014 - PMC - PubMed
    1. Goshua G, Pine AB, Meizlish ML, Chang CH, Zhang H, Bahel P, Baluha A, Bar N, Bona RD, Burns AJ, et al. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. Lancet Haematol. 2020;7:e575–e582. doi: 10.1016/S2352-3026(20)30216-7 - PMC - PubMed
    1. O’Sullivan JM, Gonagle DM, Ward SE, Preston RJS, O’Donnell JS. Endothelial cells orchestrate COVID-19 coagulopathy. Lancet Haematol. 2020;7:e553–e555. doi: 10.1016/S2352-3026(20)30215-5 - PMC - PubMed

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