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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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Severe COVID-19 Infection Associated with Endothelial Dysfunction Induces Multiple Organ Dysfunction: A Review of

Yujiro Matsuishi1,2,3, Bryan J Mathis4, Nobutake Shimojo1

  • 1Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.

Biomedicines
|April 3, 2021
PubMed

Insights

COVID-19 can cause severe organ damage through endothelial dysfunction, leading to conditions like ARDS and multi-organ failure. Therapies targeting endothelial function may improve patient outcomes.

Area of Science:

  • Cardiovascular Science
  • Infectious Diseases
  • Pathology

Background:

  • The COVID-19 pandemic has highlighted severe health complications beyond respiratory issues.
  • Endothelial dysfunction is implicated in the exacerbation of COVID-19 by chronic conditions like diabetes and cardiovascular disease.
  • Excessive inflammation in COVID-19 contributes to acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome (MODS).

Purpose of the Study:

  • To review the impact of immune-mediated endothelial dysfunction on organ injuries in COVID-19 patients.
  • To discuss the mechanisms leading to multi-organ dysfunction in severe COVID-19.
  • To explore potential therapeutic strategies targeting endothelial dysfunction and bradykinin storm.

Main Methods:

  • Literature review and synthesis of existing research on COVID-19 pathophysiology.
  • Analysis of studies detailing organ-specific injuries (heart, brain, kidney, liver) in COVID-19.
  • Discussion of pharmacological interventions for endothelial dysfunction.

Main Results:

  • COVID-19 is associated with significant heart injuries, ischemic stroke, hemorrhage, acute kidney injury, and liver injury.
  • Immune-mediated endothelial dysfunction is a key factor in the development of multi-organ dysfunction syndrome in COVID-19.
  • Excessive inflammation, thrombosis, and disseminated intravascular coagulation (DIC) contribute to mortality.

Conclusions:

  • Maintaining endothelial integrity is critical for improving prognosis in COVID-19 patients.
  • Therapeutic interventions aimed at improving endothelial function show promise.
  • Angiotensin receptor blockers and ACE inhibitors may offer benefits by addressing endothelial dysfunction and bradykinin storm.

Keywords:
ACE-IACE2ARBsCOVID-19bradykininendothelial dysfunction

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