H3K27M-mutant diffuse midline glioma with extensive intratumoral microthrombi in a young adult with COVID-19-associated coagulopathy

Pun, Matthew; Haggerty-Skeans, James; Pratt, Drew; Fudym, Yelena; Al-Holou, Wajd N.; Camelo-Piragua, Sandra; Venneti, Sriram

doi:10.1007/s00401-020-02184-0

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Microthrombi have been observed clinically in multiple organs: in the heart, resulting in acute myocardial infarction [ 72 ], within tumors [ 73 ], in the lungs [ 74 , 75 ] and in the kidneys, resulting in acute renal failure [ 76 , 77 ], whereas autopsy findings have revealed more widespread microthrombosis elsewhere [ 9 , 12 , 13 , 39 , 77 , 78 ]. Heart failure has been found in almost a third of hospitalized COVID patients and is the second leading cause of death following ARDS [ 79 ].…”

Section: Hypercoagulabilitymentioning

confidence: 99%

The Central Role of Fibrinolytic Response in COVID-19—A Hematologist’s Perspective

Kwaan

Lindholm

2021

IJMS

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The novel coronavirus disease (COVID-19) has many characteristics common to those in two other coronavirus acute respiratory diseases, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). They are all highly contagious and have severe pulmonary complications. Clinically, patients with COVID-19 run a rapidly progressive course of an acute respiratory tract infection with fever, sore throat, cough, headache and fatigue, complicated by severe pneumonia often leading to acute respiratory distress syndrome (ARDS). The infection also involves other organs throughout the body. In all three viral illnesses, the fibrinolytic system plays an active role in each phase of the pathogenesis. During transmission, the renin-aldosterone-angiotensin-system (RAAS) is involved with the spike protein of SARS-CoV-2, attaching to its natural receptor angiotensin-converting enzyme 2 (ACE 2) in host cells. Both tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) are closely linked to the RAAS. In lesions in the lung, kidney and other organs, the two plasminogen activators urokinase-type plasminogen activator (uPA) and tissue plasminogen activator (tPA), along with their inhibitor, plasminogen activator 1 (PAI-1), are involved. The altered fibrinolytic balance enables the development of a hypercoagulable state. In this article, evidence for the central role of fibrinolysis is reviewed, and the possible drug targets at multiple sites in the fibrinolytic pathways are discussed.

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Section: Hypercoagulabilitymentioning

confidence: 99%

The Central Role of Fibrinolytic Response in COVID-19—A Hematologist’s Perspective

Kwaan

Lindholm

2021

IJMS

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Neuropathological findings in COVID-19: an autopsy cohort

Eschbacher¹,

Larsen²,

Moyer³

et al. 2022

Journal of Neuropathology &Amp; Experimental Neurology

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The literature regarding the neuropathological findings in cases of SARS-CoV-2 infection, which causes coronavirus disease 2019 (COVID-19), is expanding. We identified 72 patients who died of COVID-19 (n = 48) or had recovered shortly before death (n = 24) and had autopsies performed at our institution (49 males, 23 females; median age at death 76.4 years, range: 0.0–95.0 years). Droplet digital polymerase chain reaction (ddPCR) for the detection of SARS-CoV-2 was performed (n = 58) in multiple brain regions. In cases the assay was successfully completed (n = 50), 98.0% were negative (n = 49) and 2% were indeterminate (n = 1). Most histologic findings were typical of the patient age demographic, such as neurodegenerative disease and arteriolosclerosis. A subset of cases demonstrated findings which may be associated with sequelae of critical illness. We identified 3 cases with destructive perivascular lesions with axonal injury, one of which also harbored perivascular demyelinating lesions. These rare cases may represent a parainfectious process versus sequelae of vascular injury. The lack of detectable SARS-CoV-2 by ddPCR or significant histologic evidence of direct infection suggests that active encephalitis is not a feature of COVID-19.

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H3K27M-mutant diffuse midline glioma with extensive intratumoral microthrombi in a young adult with COVID-19-associated coagulopathy

Cited by 2 publications

References 10 publications

The Central Role of Fibrinolytic Response in COVID-19—A Hematologist’s Perspective

The Central Role of Fibrinolytic Response in COVID-19—A Hematologist’s Perspective

Neuropathological findings in COVID-19: an autopsy cohort

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