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Dysfunctional Coagulation in COVID-19: From Cell to Bedside

Jie Wang1,2, Ardan M Saguner3, Jiaqi An4,5

  • 1Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, China.

Advances in Therapy
|June 7, 2020
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, leading to multisystem disease and dysfunctional coagulation. Understanding these mechanisms is crucial for developing effective anticoagulation therapies to reduce COVID-19 mortality.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Hematology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, causing COVID-19, can result in multisystem disease.
  • Human angiotensin-converting enzyme 2 (ACE2) is a key receptor for SARS-CoV-2, and its dysfunction is implicated in COVID-19 pathogenesis.
  • Dysfunctional coagulation is a significant risk factor for severe COVID-19 and mortality.

Purpose of the Study:

  • To explore the mechanisms linking ACE2 dysfunction, endotheliitis, and innate immune responses to coagulation abnormalities in COVID-19.
  • To highlight the importance of understanding these mechanisms for developing effective anticoagulation strategies.

Main Methods:

  • Review of existing literature on SARS-CoV-2, ACE2 function, renin-angiotensin system, endotheliitis, and coagulation.
  • Analysis of the interplay between innate immunity, inflammation, and coagulation in COVID-19 patients.

Main Results:

  • ACE2 dysfunction contributes to renin-angiotensin system abnormalities and systemic endotheliitis.
  • Innate immune responses and inflammation play a role in the development of COVID-19-associated coagulopathy.
  • Dysfunctional coagulation is a critical factor in COVID-19 severity and fatality.

Conclusions:

  • Understanding the complex mechanisms of dysfunctional coagulation in COVID-19 is essential.
  • Targeting these mechanisms with appropriate anticoagulation therapies may improve patient outcomes and reduce mortality.
Keywords:
ACE2COVID-19Dysfunctional coagulationSARS-CoV-2

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