Endothelial contribution to COVID-19: an update on mechanisms and therapeutic implications. (March 2022)

• Record Type: Journal Article
• Authors: Ma, Zhangjing; Yang, Kevin Y.; Huang, Yu; Lui, Kathy O.
• Is Part Of: Journal of molecular and cellular cardiology. Volume 164(2022)
• Page Start: 69
• Page End: 82
• Publication Date: 2022-03
• Subjects: COVID-19 -- SARS-CoV-2 -- endothelial dysfunction -- immunity -- thrombosis; Cardiology -- Periodicals; Heart Diseases -- Periodicals; Molecular Biology -- Periodicals; Cardiologie -- Périodiques; Cardiology; Electronic journals; Periodicals; 616.12
• DOI: 10.1016/j.yjmcc.2021.11.010
• Languages: English
• ISSNs: 0022-2828

Abstract

Abstract: The global propagation of SARS-CoV-2 leads to an unprecedented public health emergency. Despite that the lungs are the primary organ targeted by COVID-19, systemic endothelial inflammation and dysfunction is observed particularly in patients with severe COVID-19, manifested by elevated endothelial injury markers, endotheliitis, and coagulopathy. Here, we review the clinical characteristics of COVID-19 associated endothelial dysfunction; and the likely pathological mechanisms underlying the disease including direct cell entry or indirect immune overreactions after SARS-CoV-2 infection. In addition, we discuss potential biomarkers that might indicate the disease severity, particularly related to the abnormal development of thrombosis that is a fatal vascular complication of severe COVID-19. Furthermore, we summarize clinical trials targeting the direct and indirect pathological pathways after SARS-CoV-2 infection to prevent or inhibit the virus induced endothelial disorders. Graphical abstract: Unlabelled Image Highlights: Endothelial dysfunction is a clinical characterization of COVID-19 particularly in severe cases regardless of age. The likely pathological mechanisms underlying the disease including direct cell entry or indirect immune overreactions after SARS-CoV-2 infection. Biomarkers are identified to indicate the disease severity, particularly related to the abnormal development of thrombosis that is a fatal vascular complication of severe COVID-19. Clinical trials targeting the direct or indirect pathological pathways after SARS-CoV-2 infection are underway to prevent or inhibit the virus induced endothelial disorders.