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Fibrinolysis Shutdown in COVID-19: Clinical Manifestations, Molecular Mechanisms, and Therapeutic Implications

Jonathan P Meizoso1, Hunter B Moore2, Ernest E Moore1

  • 1Ernest E Moore Shock Trauma Center, Denver Health Medical Center, University of Colorado, Denver, CO.

Journal of the American College of Surgeons
|March 26, 2021
PubMed

Insights

COVID-19 causes severe respiratory distress (ARDS) due to blood clots. This review explores fibrinolysis shutdown, a key factor in COVID-19 hypercoagulability, and discusses treatment targets.

Area of Science:

  • * Infectious Disease Epidemiology
  • * Hematology
  • * Pulmonary Medicine

Background:

  • * The COVID-19 pandemic presents a significant global health challenge.
  • * Severe COVID-19 cases often involve Acute Respiratory Distress Syndrome (ARDS), linked to microvascular thrombosis.
  • * A hypercoagulable state, characterized by a prothrombotic condition and impaired fibrinolysis, is a hallmark of COVID-19.

Purpose of the Study:

  • * To detail the clinical manifestations and outcomes of fibrinolysis shutdown in COVID-19 patients.
  • * To examine the molecular mechanisms underlying dysregulated fibrinolysis in COVID-19.
  • * To explore potential therapeutic strategies and targets for managing severe COVID-19.

Main Methods:

  • * Literature review of existing studies on COVID-19, thrombosis, and fibrinolysis.
  • * Analysis of molecular pathways involved in coagulation and fibrinolysis.
  • * Synthesis of clinical data on patient outcomes related to fibrinolysis shutdown.

Main Results:

  • * Fibrinolysis shutdown is a prominent feature in severe COVID-19, contributing to thrombotic complications.
  • * Specific molecular mechanisms driving dysregulated fibrinolysis in COVID-19 have been identified.
  • * Impaired fibrinolysis is associated with poorer outcomes in patients with severe COVID-19.

Conclusions:

  • * Fibrinolysis shutdown plays a critical role in the pathophysiology of severe COVID-19.
  • * Understanding these mechanisms offers opportunities for targeted therapeutic interventions.
  • * Further research into modulating fibrinolysis may improve outcomes for COVID-19 patients.

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