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Looking beyond pulmonary disease in COVID-19: A lesson from patients with cystic fibrosis

Sara Manti1, Giuseppe Fabio Parisi1, Maria Papale1

  • 1Department of Clinical and Experimental Medicine, Pediatric Respiratory Unit, San Marco Hospital, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.

Medical Hypotheses
|January 9, 2021
PubMed

Insights

The study suggests Coronavirus disease 2019 (COVID-19) is primarily an endothelial dysfunction, not just a respiratory illness. Researchers should focus on treatments targeting endothelial stabilization for better outcomes against SARS-CoV-2 infection.

Area of Science:

  • Virology
  • Pathology
  • Cardiovascular Science

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in millions of cases and deaths globally.
  • Despite extensive research, the precise nature of SARS-CoV-2 infection and its primary target remain subjects of ongoing investigation.
  • The World Health Organization declared COVID-19 a pandemic, highlighting its significant global health impact.

Discussion:

  • This paper presents a rationale for viewing SARS-CoV-2 infection as a condition characterized by endothelial dysfunction, challenging the predominant focus on respiratory disease.
  • The widespread effects of COVID-19 on various organ systems suggest a systemic vascular component that may be more critical than previously emphasized.

Key Insights:

  • Emerging evidence indicates that SARS-CoV-2 directly impacts endothelial cells, leading to widespread inflammation and impaired vascular function.
  • Endothelial dysfunction, characterized by impaired vasodilation, increased permeability, and a pro-thrombotic state, is proposed as a central mechanism in COVID-19 pathogenesis.

Outlook:

  • Future research should prioritize investigating the role of endothelial dysfunction in COVID-19 severity and patient outcomes.
  • Developing therapeutic strategies aimed at stabilizing the endothelium and restoring vascular integrity may offer novel treatment avenues for COVID-19, potentially surpassing lung-focused interventions.

Keywords:
COVID-19Cystic fibrosisEndothelial dysfunctionPulmonary diseaseSARS-CoV-2 infection

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