Pulmonary and systemic pathology in COVID-19—holistic pathological analyses

Jonigk, Danny; Werlein, Christopher; Lee, Peter; Kauczor, Hans‐Ulrich; Ackermann, Maximilian

doi:10.3238/arztebl.m2022.0231

Cited by 9 publications

(6 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other common areas of ACE2 expression in the lungs include the lung fibroblasts and bronchial and tracheal epithelial cells [ 69 ]. Acute respiratory distress syndrome (ARDS) is considered a frequent and prominent complication of inpatient COVID-19 infection [ 78 ]. The role of ACE2 and its polymorphisms was well explored even in the early 2000s, where it was documented that higher expressions translated to greater severity of ARDS and outcomes [ 79 ].…”

Section: Disease Statesmentioning

confidence: 99%

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

et al. 2023

View full text Add to dashboard Cite

Angiotensin-converting enzyme 2 (ACE2), first discovered in 2000, serves as an important counterregulatory enzyme to the angiotensin II-mediated vasoconstrictive, pro-inflammatory, and pro-fibrotic actions of the renin–angiotensin system (RAS). Conversion of angiotensin II to the peptide angiotensin 1–7 (ANG 1–7) exerts protective vasodilatory, anti-inflammatory, and anti-fibrotic actions through interaction with the MasR receptor. There are many important considerations when noting the role of ACE2 in the pathogenesis and sequelae of COVID-19 infection. ACE2, in the role of COVID-19 infection, was recognized early in 2020 at the beginning of the pandemic as a cell membrane-bound and soluble binding site for the viral spike protein facilitating entering into tissue cells expressing ACE2, such as the lungs, heart, gut, and kidneys. Mechanisms exist that alter the magnitude of circulating and membrane-bound ACE2 (e.g., SARS-CoV-2 infection, viral variants, patient characteristics, chronic disease states, and the degree of cell surface expression of ACE2) and the influence these mechanisms have on the severity of disease and associated complications (e.g., respiratory failure, systemic inflammatory response syndrome, acute myocarditis, acute kidney injury). Several medications alter the ACE2 receptor expression, but whether these medications can influence the course of the disease and improve outcomes is unclear. In this review, we will discuss what is known about the interrelation of SARS-CoV-2, ACE2 and the factors that may contribute to the variability of its expression and potential contributors to the severity of COVID-19 infection.

show abstract

Section: Disease Statesmentioning

confidence: 99%

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Additionally, the combination of these comorbidities further escalates the risk of morbidity and mortality. Endothelial dysfunction, when exacerbated by the cytokine storm triggered by SARS-CoV-2, emerges as the primary cause of death [ 32 , 33 , 34 ]. Viral toxicity also contributes to the severity of COVID-19.…”

Section: Low-grade Chronic Inflammation and Its Consequences In Covid...mentioning

confidence: 99%

The Management of COVID-19-Related Coagulopathy: A Focus on the Challenges of Metabolic and Vascular Diseases

Szilveszter¹,

Pál

Simon-Szabó

et al. 2023

IJMS

View full text Add to dashboard Cite

The course of COVID-19 is highly dependent on the associated cardiometabolic comorbidities of the patient, which worsen the prognosis of coronavirus infection, mainly due to systemic inflammation, endothelium dysfunction, and thrombosis. A search on the recent medical literature was performed in five languages, using the PubMed, Embase, Cochrane, and Google Scholar databases, for the review of data regarding the management of patients with a high risk for severe COVID-19, focusing on the associated coagulopathy. Special features of COVID-19 management are presented, based on the underlying conditions (obesity, diabetes mellitus, and cardiovascular diseases), emphasizing the necessity of a modern, holistic approach to thromboembolic states. The latest findings regarding the most efficient therapeutic approaches are included in the article, offering guidance for medical professionals in severe, complicated cases of SARS-CoV-2 infection. We can conclude that severe COVID-19 is closely related to vascular inflammation and intense cytokine release leading to hemostasis disorders. Overweight, hyperglycemia, cardiovascular diseases, and old age are important risk factors for severe outcomes of coronavirus infection, involving a hypercoagulable state. Early diagnosis and proper therapy in complicated SARS-CoV-2-infected cases could reduce mortality and the need for intensive care during hospitalization in patients with cardiometabolic comorbidities.

show abstract

“… 145 Intussusceptive angiogenesis may contribute to COVID-19 abnormalities as it disturbs the regular blood flow, leading to further microthrombi formation. 146 Thus, avoiding microthrombi formation and targeting VEGF are potential mechanisms for reducing blood vessel abnormalities, including edema and intussusceptive angiogenesis, in SARS-CoV-2-infected patients. Furthermore, the role of NETs in the enhanced vascular permeability observed in COVID-19 patients has not been determined yet, but as it contributes to the microthrombi formation, 92 targeting NETs is another potential mechanism of reducing blood vessel leakage.…”

Section: Changes In Blood Vessel Permeability Due To Coronaviruses An...mentioning

confidence: 99%

Effect of coronaviruses on blood vessel permeability: potential therapeutic targets

Machado

Dias

Cortes

et al. 2023

Ther Adv Respir Dis

View full text Add to dashboard Cite

Coronavirus-induced diseases have afflicted humanity for several decades. This scenario was aggravated by the emergence of the coronavirus disease 2019 (named COVID-19) in Wuhan, China, in December 2019. Since then, COVID-19 has killed millions of people worldwide, probably the most devastating pandemic since HIV/AIDS. This review aimed to bring together important updated aspects related to coronavirus-induced diseases and the enhanced vascular permeability observed mainly in the lungs of affected people. The dysregulated vascular permeability in the lungs is of fundamental importance for coronaviruses-caused morbidity and mortality. Thus, as described in this review, it is a target of new and old drugs.

show abstract

Pulmonary and systemic pathology in COVID-19—holistic pathological analyses

Abstract: OVID-19 (1) stellt den dritten, weltweiten Coronavirus-assoziierten Erkrankungsausbruch innerhalb von 20 Jahren dar -nach dem "severe acute respiratory syndrome" (SARS) 2002-2004 (e1) und dem "middle east respiratory syndrome" (MERS) *Die Autoren teilen sich die Letztautorenschaft.

Cited by 9 publications

References 55 publications

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

The Management of COVID-19-Related Coagulopathy: A Focus on the Challenges of Metabolic and Vascular Diseases

Effect of coronaviruses on blood vessel permeability: potential therapeutic targets

Contact Info

Product

Resources

About