The
coronavirus 2019 [COVID-19]
pandemic is caused by
severe acute respiratory syndrome coronavirus 2 [
SARS-CoV-2]
virus.
Infection with
SARS-CoV-2 is associated with an
acute respiratory distress syndrome,
thrombosis and a high rate of
mortality. Thrombotic events increase with severity.
Tissue factor [TF] expression is increased during viral and
bacterial infections. This
review summarizes studies that have examined TF expression in response to SARS-CoV-2 infection.
SARS-CoV-2 virus and its
proteins upregulate TF
mRNA,
protein and activity in a variety of
cells, including bronchial
epithelial cells,
neutrophils,
monocytes,
macrophages,
endothelial cells and adventitial
fibroblasts. COVID-19
patients have increased TF expression in
lungs,
bronchoalveolar lavage fluid and circulating
extracellular vesicles. The increase in TF was associated with coagulation activation markers,
thrombosis, inflammatory markers, severity of
disease and
mortality. Taken together, the studies suggest that TF
plays a central
role in
thrombosis in COVID-19. TF may be a useful prognostic marker and
therapeutic target to reduce
thrombosis and
inflammation.