Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan;31(1):1-5.
doi: 10.1016/j.tcm.2020.10.005. Epub 2020 Oct 14.

COVID-19 - A vascular disease

Hasan K Siddiqi  1 , Peter Libby  2 , Paul M Ridker  1
Affiliations
Review

COVID-19 - A vascular disease

Hasan K Siddiqi et al. Trends Cardiovasc Med. 2021 Jan.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to multi-system dysfunction with emerging evidence suggesting that SARS-CoV-2-mediated endothelial injury is an important effector of the virus. Potential therapies that address vascular system dysfunction and its sequelae may have an important role in treating SARS-CoV-2 infection and its long-lasting effects.

Keywords: Coagulation; Endothelium; Inflammation; Microvessels; Thrombosis.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest Hasan Siddiqi: No disclosures Peter Libby: Dr. Libby is an unpaid consultant to, or involved in clinical trials for Amgen, AstraZeneca, Baim Institute, Beren Therapeutics, Esperion, Therapeutics, Genentech, Kancera, Kowa Pharmaceuticals, Medimmune, Merck, Norvo Nordisk, Merck, Novartis, Pfizer, Sanofi-Regeneron. Dr. Libby is a member of scientific advisory board for Amgen, Corvidia Therapeutics, DalCor Pharmaceuticals, Kowa Pharmaceuticals, Olatec Therapeutics, Medimmune, Novartis, XBiotech, Inc. Dr. Libby's laboratory has received research funding in the last 2 years from Novartis. Dr. Libby is on the Board of Directors of XBiotech, Inc. Dr. Libby has a financial interest in Xbiotech, a company developing therapeutic human antibodies. Dr. Libby's interests were reviewed and are managed by Brigham and Women's Hospital and Partners HealthCare in accordance with their conflict of interest policies. Dr. Libby receives funding support from the National Heart, Lung, and Blood Institute (1R01HL134892), the American Heart Association (18CSA34080399), and the RRM Charitable Fund. Paul Ridker: Dr Ridker has received research grant support from Kowa, Novartis, NHLBI, NCI, and Amarin (unrelated to this manuscript) and served as a consultant to Novartis, Jansen, CiviBiopharm, Corvidia, Flame, Agepha, and Inflazome, (unrelated to this manuscript). Dr. Ridker is also part of the National Institutes of Health Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) collaborative steering committee.

Figures

Fig. 1
Fig. 1
SARS-CoV-2 Induced Endothelial Injury Legend: A schematic of SARS-CoV-2 infection and proposed resulting endothelial injury, involving immune activation, pro-thrombotic milieu, and RAAS dysregulation. These insults interact with each other to cause end-organ dysfunction that is manifest in many COVID-19 patients. TMPRSS2 = Transmembrane protease serine 2; ADAM17 = A disintegrin and metalloproteinase 17; TNF = Tumor necrosis factor; TNFr = Tumor necrosis factor receptor; TLR = toll-like receptor; DAMPs = Damage-associated molecular patterns; PAMPs = Pathogen-associated molecular patterns; PAI-1 = plasminogen activator inhibitor-1; vWF = von Willebrand factor; eNOS = endothelial nitric oxide; tPA = tissue plasminogen activator; AT1R = angiotensin 1 receptor; ARDS = acute respiratory distress syndrome Created with BioRender.com.
See this image and copyright information in PMC

Comment in

References

    1. Liu T., Luo S., Libby P., Shi G.-P. Cathepsin L-selective inhibitors: A potentially promising treatment for COVID-19 patients. Pharmacol Therapeut. Sep 2020;213 - PMC - PubMed
    1. Hamming I., Timens W., Bulthuis M., Lely A., Navis G., van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. Jun 2004;203(2):631–637. - PMC - PubMed
    1. Ackermann M., Verleden S.E., Kuehnel M., Haverich A., Welte T., Laenger F. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 2020 Jul 9;383(2):120–128. - PMC - PubMed
    1. Libby P., Lüscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020 Aug 21;41(32):3038–3044. - PMC - PubMed
    1. Giamarellos-Bourboulis E.J., Netea M.G., Rovina N., Akinosoglou K., Antoniadou A., Antonakos N. Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell Host Microbe. Jun 2020;27(6):992–1000. .e3. - PMC - PubMed

MeSH terms