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Monitoring Changes in Human Umbilical Vein Endothelial Cells upon Viral Infection Using Impedance-Based Real-Time Cell Analysis
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The vascular nature of COVID-19

Matthijs Oudkerk1,2, Dirkjan Kuijpers3, Sytse F Oudkerk4

  • 1University of Groningen, Faculty of Medical Sciences, Groningen, Netherlands.

The British Journal of Radiology
|August 1, 2020
PubMed

Insights

COVID-19 causes microvascular damage, leading to widespread perfusion issues and thrombosis. Early anticoagulant therapy and monitoring are crucial for managing this vascular disease.

Area of Science:

  • Vascular Biology
  • Infectious Diseases
  • Pathology

Background:

  • COVID-19 is associated with increased mortality, elevated D-dimer levels, and a prothrombotic state.
  • Existing diagnostic and treatment guidelines for COVID-19 may not fully address the observed thromboembolic complications.
  • A new vascular disease concept has been proposed to explain COVID-19's clinical manifestations.

Purpose of the Study:

  • To analyze current medical, laboratory, and imaging data on COVID-19.
  • To investigate the underlying pathophysiology of COVID-19 beyond impaired pulmonary ventilation.
  • To establish the role of microvascular damage and thrombosis in COVID-19.

Main Methods:

  • Comprehensive review of medical, laboratory, and imaging data from COVID-19 patients.
  • Pathological and imaging investigations to assess organ perfusion and microvasculature.
  • Analysis of viral impact (SARS-1 and SARS-2) on vascular structures.

Main Results:

  • COVID-19 symptoms and diagnostic findings are not solely explained by impaired lung ventilation.
  • Perfusion disturbances, initially in the lungs and subsequently in other organs, characterize the COVID-19 syndrome.
  • Microvascular damage by SARS-CoV-2 leads to microthrombotic changes, progressing to macrothrombosis and emboli.

Conclusions:

  • COVID-19 should be understood as a systemic vascular disease driven by viral-induced microvascular damage.
  • Anticoagulant prophylaxis, vigilant laboratory and CT imaging monitoring, and prompt anticoagulant therapy are indicated.
  • This approach aims to mitigate thromboembolic complications and improve outcomes in COVID-19 patients.

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