"War to the knife" against thromboinflammation to protect endothelial function of COVID-19 patients.
Crit Care
; 24(1): 365, 2020 06 19.
Article
in English
| MEDLINE | ID: covidwho-608395
ABSTRACT
In this viewpoint, we summarize the relevance of thromboinflammation in COVID-19 and discuss potential mechanisms of endothelial injury as a key point for the development of lung and distant organ dysfunction, with a focus on direct viral infection and cytokine-mediated injury. Entanglement between inflammation and coagulation and resistance to heparin provide a rationale to consider other therapeutic approaches in order to preserve endothelial function and limit microthrombosis, especially in severe forms. These strategies include nebulized heparin, N-acetylcysteine, plasma exchange and/or fresh frozen plasma, plasma derivatives to increase the level of endogenous anticoagulants (tissue factor pathway inhibitor, activated protein C, thrombomodulin, antithrombin), dipyridamole, complement blockers, different types of stem cells, and extracellular vesicles. An integrated therapy including these drugs has the potential to improve outcomes in COVID-19.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Thrombosis
/
Coronavirus Infections
/
Endothelial Cells
/
Inflammation
Limits:
Humans
Language:
English
Journal:
Crit Care
Year:
2020
Document Type:
Article
Affiliation country:
S13054-020-03060-9
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