A comprehensive review of vascular complications in COVID-19

Acharya, Yogesh; Alameer, Aqeel; Calpin, Gavin G.; Alkhattab, Maha; Sultan, Sherif

doi:10.1007/s11239-021-02593-2

Cited by 31 publications

(22 citation statements)

References 88 publications

(109 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…COVID-19 is associated with vascular complications including increased risk of micro-and macrovascular thromboembolism [39]. Several alterations in the coagulation pathway promoting a hypercoagulable state have been linked to COVID-19-associated coagulopathy [40]. In the abdomen, findings of bowel ischemia due to mesenteric and portal vein thrombosis, arterial mesenteric thrombosis and arterial dissections of the splanchnic vessels have been described [41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

View full text Add to dashboard Cite

Background Despite emerging reports of secondary sclerosing cholangitis (SSC) in critically ill COVID-19 patients little is known about its imaging findings. It presents as delayed progressive cholestatic liver injury with risk of progression to cirrhosis. Diagnosis cannot be made based on clinical presentation and laboratory markers alone. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) can aid in the diagnosis. The aim of this study was to describe MRI/MRCP imaging features of COVID-19-associated SSC. Results Seventeen patients (mean age 60.5 years, 15 male) who underwent MRI/MRCP were included. All had been admitted to intensive care unit (ICU) (median duration of ICU stay 10 weeks, range, 2–28 weeks) and developed acute respiratory distress syndrome requiring mechanical ventilation. On imaging, all patients had intrahepatic bile duct strictures and 10 (58.8%) had associated upstream dilatation. Intrahepatic bile duct beading was seen in 14 cases (82.3%). Only one patient (5.9%) had extrahepatic bile duct stricturing. Patchy arterial phase hyperenhancement and high signal on T2- and diffusion-weighted images were seen in 7 cases (53.8%) and 9 cases (52.9%), respectively. Biliary casts were seen in 2 cases (11.8%). Periportal lymphadenopathy and vascular complications were not seen. Conclusion On MRI/MRCP, COVID-19-associated SSC presents with multiple intrahepatic bile duct strictures with or without upstream dilatation and intrahepatic bile duct beading. Surrounding hepatic parenchymal changes including alterations in enhancement and T2 signal are common. The extrahepatic biliary tree was typically spared and periportal lymphadenopathy was missing in all patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In light of the current pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for the scope of this review it is important to mention vascular complications that are linked to TLRs immune response ( 173 ). SARS-CoV-2 induces release of proinflammatory cytokines and activation of procoagulant factors that activate coagulation cascades leading to thrombosis, rupture of atherosclerotic plaques and ischemic events ( 174 , 175 ).…”

Section: Sars-cov-2 and Tlr Signalingmentioning

confidence: 99%

The Intriguing Role of TLR Accessory Molecules in Cardiovascular Health and Disease

Bezhaeva

Karper²,

Quax

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Activation of Toll like receptors (TLR) plays an important role in cardiovascular disease development, progression and outcomes. Complex TLR mediated signaling affects vascular and cardiac function including tissue remodeling and repair. Being central components of both innate and adaptive arms of the immune system, TLRs interact as pattern recognition receptors with a series of exogenous ligands and endogenous molecules or so-called danger associated molecular patterns (DAMPs) that are released upon tissue injury and cellular stress. Besides immune cells, a number of structural cells within the cardiovascular system, including endothelial cells, smooth muscle cells, fibroblasts and cardiac myocytes express TLRs and are able to release or sense DAMPs. Local activation of TLR-mediated signaling cascade induces cardiovascular tissue repair but in a presence of constant stimuli can overshoot and cause chronic inflammation and tissue damage. TLR accessory molecules are essential in guiding and dampening these responses toward an adequate reaction. Furthermore, accessory molecules assure specific and exclusive TLR-mediated signal transduction for distinct cells and pathways involved in the pathogenesis of cardiovascular diseases. Although much has been learned about TLRs activation in cardiovascular remodeling, the exact role of TLR accessory molecules is not entirely understood. Deeper understanding of the role of TLR accessory molecules in cardiovascular system may open therapeutic avenues aiming at manipulation of inflammatory response in cardiovascular disease. The present review outlines accessory molecules for membrane TLRs that are involved in cardiovascular disease progression. We first summarize the up-to-date knowledge on TLR signaling focusing on membrane TLRs and their ligands that play a key role in cardiovascular system. We then survey the current evidence of the contribution of TLRs accessory molecules in vascular and cardiac remodeling including myocardial infarction, heart failure, stroke, atherosclerosis, vein graft disease and arterio-venous fistula failure.

show abstract

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an aggressive infection with potentially serious health consequences, coronavirus disease 2019 (COVID-19). Although COVID-19 primarily causes respiratory infection, recent studies have shifted their attention to vascular complications of this disease, including alarming thromboembolism [1]. This case series underscores the importance of recognizing hypercoagulability as a cause of arterial thrombus presenting as bowel ischemia and blue toe syndrome in patients with COVID-19.…”

Section: Introductionmentioning

confidence: 82%

“…Inflammatory cytokine release mediates atherosclerosis and results in hemodynamic changes because of the induction of procoagulant mediators. It is believed that a storm of inflammatory mediators such as cytokines triggered by SARS-CoV-2 results in irreversible multisystem inflammation that can partially present as abnormal hemostasis and coagulopathy, further aggravating organ injury [1].…”

Section: Discussionmentioning

confidence: 99%

Rare Thrombotic Complications of COVID-19: A Case Series

Vellanki¹,

Kumar²,

Stoffel³

et al. 2022

Cureus

View full text Add to dashboard Cite

Coronavirus disease 2019 is known to manifest with bilateral pneumonia and acute respiratory distress syndrome. This infection with severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) is alarming because it not only affects the respiratory system but may also cause thromboembolic events. Multiple studies have reported procoagulation/hypercoagulable complications in COVID-19. This case series is a valuable addition to the literature because it reflects unique presentations of thrombotic events in COVID-19 patients. We report two cases in which patients presented with thromboembolic complications secondary to COVID-19 infection: one with severe bowel ischemia and the other with blue toe syndrome. To formulate management strategies to prevent fatal outcomes for patients with COVID-19, physicians must be vigilant in identifying life-threatening thromboembolic complications from this disease.

show abstract

A comprehensive review of vascular complications in COVID-19

Cited by 31 publications

References 88 publications

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

The Intriguing Role of TLR Accessory Molecules in Cardiovascular Health and Disease

Rare Thrombotic Complications of COVID-19: A Case Series

Contact Info

Product

Resources

About