COVID-19 and Peripheral Artery Thrombosis: A Mini Review

Goudarzi, Ehsan; Yousefimoghaddam, Fateme; Ramandi, Alireza; Khaheshi, Isa

doi:10.1016/j.cpcardiol.2021.100992

Cited by 6 publications

(6 citation statements)

References 50 publications

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“…Thrombolytic drugs are a potential treatment for COVID-19 thrombotic complications ( 80 , 81 ) and ARDS ( 82 ). In China, drugs commonly used for thrombolytic therapy include urokinase, streptokinase, and rt-PA, which promote fibrinolysis by activating plasminogen ( Table 2 , row 13-15).…”

Section: Discussionmentioning

confidence: 99%

An early warning indicator of mortality risk in patients with COVID-19: the neutrophil extracellular traps/neutrophilic segmented granulocyte ratio

Wang,

Qin,

et al. 2024

Front. Immunol.

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BackgroundNeutrophil extracellular traps (NETs) play a key role in thrombus formation in patients with coronavirus disease 2019 (COVID-19). However, the existing detection and observation methods for NETs are limited in their ability to provide quantitative, convenient, and accurate descriptions of in situ NETs. Therefore, establishing a quantitative description of the relationship between NETs and thrombosis remains a challenge.ObjectiveWe employed morphological observations of blood cells and statistical analyses to investigate the correlation between the NETs/neutrophilic segmented granulocyte ratio and mortality risk in patients with COVID-19.MethodsPeripheral blood samples were collected from 117 hospitalized patients with COVID-19 between November 2022 and February 2023, and various blood cell parameters were measured. Two types of smudge cells were observed in the blood and counted: lymphatic and neutral smudge cells. Statistical data analysis was used to establish COVID-19 mortality risk assessment indicators.ResultsMorphological observations of neutrophilic smudge cells revealed swelling, eruption, and NETs formation in the neutrophil nuclei. Subsequently, the NETs/neutrophilic segmented granulocyte ratio (NNSR) was calculated. A high concentration of NETs poses a fatal risk for thrombus formation in patients. Statistical analysis indicated that a high NNSR was more suitable for evaluating the risk of death in patients with COVID-19 compared to elevated fibrinogen (FIB) and D-dimer (DD) levels.ConclusionObserving blood cell morphology is an effective method for the detection of NETs, NNSR are important markers for revealing the mortality risk of patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

An early warning indicator of mortality risk in patients with COVID-19: the neutrophil extracellular traps/neutrophilic segmented granulocyte ratio

Wang,

Qin,

et al. 2024

Front. Immunol.

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“…Similar to other coronaviruses, a significant association has been found between COVID-19 and the risk of thrombosis. A meta-analysis found that arterial thrombosis occurs in 4.4% of cases ( 14 ). The pathophysiology of thromboembolism in COVID-19 involves several aspects.…”

Section: Discussionmentioning

confidence: 99%

Acute limb ischemia caused by floating thrombus in the aorta: a case report and literature review

Guo

2023

Front. Cardiovasc. Med.

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This report presents a patient with rheumatoid arthritis and COVID-19 infection one month earlier who experienced embolic episodes resulting in acute lower-limb ischemia from an unusual source. The blood flow was successfully restored by femoropopliteal thromboembolectomy. In determining the source of the embolism, the patient underwent electrocardiogram, transthoracic echocardiogram, and aortic CTA. The latter revealed a large, pedunculated, and mobile thrombus arising from the aortic arch and the descending thoracic aorta. Considering the patient's general health condition, we performed anticoagulation of the floating thrombus in the aortic lumen. The mechanism of aortic floating thrombosis exhibits considerable complexity. There are no standardized treatment protocols or clinical guidelines, and its treatment mainly includes open surgery, aortic endoluminal stent -graft insertion and pharmacological anticoagulation. Treatment strategy should be based on the cause of the disease and the patient's physical condition.

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“…Given the complexity and multifactor dependence of the mechanism, the aetiology of hypercoagulopathy in Covid‐19 is not precisely explained. Downregulation of ACE2 by SARS‐CoV‐2 and subsequent Ang II accumulation, 167 pneumonia‐induced hypoxia, 168 and release of neutrophil extracellular traps (NETs) 169 are among proposed mechanisms for the condition. However, endotheliopathy and massive inflammatory response have been indicated as two main features of prothrombotic presentations associated with Covid‐19.…”

Section: The Indirect Effects On the Nervous Systemmentioning

confidence: 99%

“…166 Given the complexity and multifactor dependence of the mechanism, the aetiology of hypercoagulopathy in Covid-19 is not precisely explained. Downregulation of ACE2 by SARS-CoV-2 and subsequent Ang II accumulation, 167 pneumonia-induced hypoxia, 168 and release of neutrophil extracellular traps (NETs) 169 stimulates neutrophils to release excessive NETs, all resulting in a higher coagulable condition. 175 Taken together, infection-triggered complement hyperactivation induces a maladaptive inflammatory and coagulatory response, which in turn, feeds back and amplifies complement activation and clot formation.…”

Section: Hypercoagulable Statementioning

confidence: 99%

Neurological complications associated with Covid‐19; molecular mechanisms and therapeutic approaches

Mehrabani

Karvandi

Maafi

et al. 2022

Reviews in Medical Virology

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With the progression of investigations on the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), neurological complications have emerged as a critical aspect of the ongoing coronavirus disease 2019 (Covid‐19) pandemic. Besides the well‐known respiratory symptoms, many neurological manifestations such as anosmia/ageusia, headaches, dizziness, seizures, and strokes have been documented in hospitalised patients. The neurotropism background of coronaviruses has led to speculation that the neurological complications are caused by the direct invasion of SARS‐CoV‐2 into the nervous system. This invasion is proposed to occur through the infection of peripheral nerves or via systemic blood circulation, termed neuronal and haematogenous routes of invasion, respectively. On the other hand, aberrant immune responses and respiratory insufficiency associated with Covid‐19 are suggested to affect the nervous system indirectly. Deleterious roles of cytokine storm and hypoxic conditions in blood‐brain barrier disruption, coagulation abnormalities, and autoimmune neuropathies are well investigated in coronavirus infections, as well as Covid‐19. Here, we review the latest discoveries focussing on possible molecular mechanisms of direct and indirect impacts of SARS‐CoV‐2 on the nervous system and try to elucidate the link between some potential therapeutic strategies and the molecular pathways.

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COVID-19 and Peripheral Artery Thrombosis: A Mini Review

Cited by 6 publications

References 50 publications

An early warning indicator of mortality risk in patients with COVID-19: the neutrophil extracellular traps/neutrophilic segmented granulocyte ratio

An early warning indicator of mortality risk in patients with COVID-19: the neutrophil extracellular traps/neutrophilic segmented granulocyte ratio

Acute limb ischemia caused by floating thrombus in the aorta: a case report and literature review

Neurological complications associated with Covid‐19; molecular mechanisms and therapeutic approaches

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