Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.210020
Jornal Vascular Brasileiro
Review Article

Quais são os mecanismos celulares relacionados aos eventos tromboembólicos em pacientes com COVID-19?

What cellular mechanisms are related to thromboembolic events in patients with COVID-19?

Cristian Rodrigues do Nascimento; Júlio Martinez Santos; Sávio Breno Pires Brito; Pedro Pereira Tenório

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Views: 1034

Resumo

Resumo: O SARS-CoV-2 é o vírus responsável pela pandemia da COVID-19. Essa doença começou a ser melhor entendida devido a outras manifestações clínicas além das respiratórias. Ao longo dos meses de atendimento aos pacientes infectados pelo vírus, foram identificadas alterações clínicas e laboratoriais que incitaram os pesquisadores a discutir sobre o potencial do SARS-CoV-2 no desencadeamento de uma resposta imunológica exacerbada capaz de alterar a homeostase endotelial, através de mecanismos diretos e indiretos. Com esse intuito, foram revisados os possíveis mecanismos que desencadeiam este fenômeno em pacientes portadores de COVID-19. Dessa forma, torna-se importante o entendimento fisiopatológico dos mecanismos imunológicos relacionados à doença para a compreensão do potencial de dano endotelial que a COVID-19 pode promover.

Palavras-chave

infecções por coronavírus, coagulação intravascular disseminada, coagulação sanguínea

Abstract

SARS-CoV-2 is the virus responsible for the COVID-19 pandemic. This disease is beginning to be better understood in terms of its other, non-respiratory, clinical manifestations. Over the course of months caring for patients infected by the virus, clinical and laboratory changes have been identified that have prompted researchers to debate the potential that SARS-CoV-2 has to trigger an exacerbated immune response that is capable of changing endothelial homeostasis through both direct and indirect mechanisms. With the intention of contributing to this debate, a review was conducted of the possible mechanisms that could trigger these phenomena in patients with COVID-19. It is important to understand the pathophysiology of the immunological mechanisms related to this disease in order to understand the potential endothelial damage that COVID-19 can provoke.

Keywords

coronavirus infections; disseminated intravascular coagulation; blood coagulation

References

1 Bikdeli B, Madhavan MV, Jimenez D, et al. COVID19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol. 2020;75(23):2950-73. http://dx.doi.org/10.1016/j.jacc.2020.04.031. PMid:32311448.

2 Hu T, Liu Y, Zhao M, Zhuang Q, Xu L, He Q. A comparison of COVID-19, SARS and MERS. PeerJ. 2020;8:e9725. http://dx.doi.org/10.7717/peerj.9725. PMid:32879801.

3 Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr. 2020;63(4):119-24. http://dx.doi.org/10.3345/cep.2020.00493. PMid:32252141.

4 Zhang S, Liu Y, Wang X, et al. SARS-CoV-2 binds platelet ACE2 to enhance thrombosis in COVID-19. J Hematol Oncol. 2020;13(1):120. http://dx.doi.org/10.1186/s13045-020-00954-7. PMid:32887634.

5 Lazzaroni MG, Piantoni S, Masneri S, et al. Coagulation dysfunction in COVID-19: the interplay between inflammation, viral infection and the coagulation system. Blood Rev. 2021;46:100745. http://dx.doi.org/10.1016/j.blre.2020.100745. PMid:32868115.

6 Costa IBSS, Bittar CS, Rizk SI, et al. O coração e a COVID-19: o que o cardiologista precisa saber. Arq Bras Cardiol. 2020;114(5):805-16. http://dx.doi.org/10.36660/abc.20200279. PMid:32401847.

7 Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8. http://dx.doi.org/10.1016/S0140-6736(20)30937-5. PMid:32325026.

8 Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620-32. http://dx.doi.org/10.3906/sag-2004-168. PMid:32299202.

9 Astuti I, Ysrafil. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response. Diabetes Metab Syndr. 2020;14(4):407-12. http://dx.doi.org/10.1016/j.dsx.2020.04.020. PMid:32335367.

10 Casella IB. Fisiopatologia da trombose associada à infecção pelo SARS-CoV-2. J Vasc Bras. 2020;19:e20200128. http://dx.doi.org/10.1590/1677-5449.200128. PMid:34211529.

11 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-40. http://dx.doi.org/10.1182/blood.2020006000. PMid:32339221.

12 Iba T, Levy JH, Levi M, Connors JM, Thachil J. Coagulopathy of coronavirus disease 2019. Crit Care Med. 2020;48(9):1358-64. http://dx.doi.org/10.1097/CCM.0000000000004458. PMid:32467443.
 


Submitted date:
01/21/2021

Accepted date:
05/05/2021

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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