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Angelini DE, Kaatz S, Rosovsky R, Zon RL, Pillai S, Robertson WE, Elavalakanar P, Patell R, Khorana A. COVID-19 and venous thromboembolism: A narrative review. Res Pract Thromb Haemost 2022; 6:e12666. [PMID: 35224417 PMCID: PMC8847419 DOI: 10.1002/rth2.12666] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/27/2021] [Accepted: 01/02/2022] [Indexed: 12/15/2022] Open
Abstract
COVID-19 (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) is associated with coagulopathy through numerous mechanisms. The reported incidence of venous thromboembolism (VTE) in hospitalized patients with COVID-19 has varied widely, and several meta-analyses have been performed to assess the overall prevalence of VTE. The novelty of this coronavirus strain along with its unique mechanisms for microvascular and macrovascular thrombosis has led to uncertainty as to how to diagnose, prevent, and treat thrombosis in patients affected by this virus. This review discusses the epidemiology and pathophysiology of thrombosis in the setting of SARS-CoV-2 infection along with an updated review on the preventative and treatment strategies for VTE associated with SARS-CoV-2 infection.
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Affiliation(s)
- Dana E. Angelini
- Department of Hematology and Medical OncologyTaussig Cancer InstituteCleveland Clinic FoundationClevelandOhioUSA
| | - Scott Kaatz
- Division of Hospital MedicineHenry Ford HospitalDetroitMichiganUSA
| | - Rachel P. Rosovsky
- Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Rebecca L. Zon
- Dana Farber Cancer Institute and Massachusetts General BrighamBostonMassachusettsUSA
| | - Shreejith Pillai
- Division of Hospital MedicineHenry Ford HospitalDetroitMichiganUSA
| | - William E. Robertson
- National Blood Clot AllianceDepartment of Emergency HealthcareDumke College of Health ProfessionsWeber State UniversityOgdenUtahUSA
| | - Pavania Elavalakanar
- Division of Hematology and Hematologic MalignanciesBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Rushad Patell
- Division of Hematology and Hematologic MalignanciesBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Alok Khorana
- Department of Hematology and Medical OncologyTaussig Cancer InstituteCleveland Clinic FoundationClevelandOhioUSA
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Ernzen K, Trask AJ, Peeples ME, Garg V, Zhao MT. Human Stem Cell Models of SARS-CoV-2 Infection in the Cardiovascular System. Stem Cell Rev Rep 2021; 17:2107-2119. [PMID: 34365591 PMCID: PMC8349465 DOI: 10.1007/s12015-021-10229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/28/2022]
Abstract
The virus responsible for coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected over 190 million people to date, causing a global pandemic. SARS-CoV-2 relies on binding of its spike glycoprotein to angiotensin-converting enzyme 2 (ACE2) for infection. In addition to fever, cough, and shortness of breath, severe cases of SARS-CoV-2 infection may result in the rapid overproduction of pro-inflammatory cytokines. This overactive immune response is known as a cytokine storm, which leads to several serious clinical manifestations such as acute respiratory distress syndrome and myocardial injury. Cardiovascular disorders such as acute coronary syndrome (ACS) and heart failure not only enhance disease progression at the onset of infection, but also arise in hospitalized patients with COVID-19. Tissue-specific differentiated cells and organoids derived from human pluripotent stem cells (hPSCs) serve as an excellent model to address how SARS-CoV-2 damages the lungs and the heart. In this review, we summarize the molecular basis of SARS-CoV-2 infection and the current clinical perspectives of the bidirectional relationship between the cardiovascular system and viral progression. Furthermore, we also address the utility of hPSCs as a dynamic model for SARS-CoV-2 research and clinical translation.
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Affiliation(s)
- Kyle Ernzen
- Center for Cardiovascular Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- MCDB Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Aaron J Trask
- Center for Cardiovascular Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Mark E Peeples
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Center for Vaccine and Immunity, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vidu Garg
- Center for Cardiovascular Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- MCDB Graduate Program, The Ohio State University, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ming-Tao Zhao
- Center for Cardiovascular Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
- MCDB Graduate Program, The Ohio State University, Columbus, OH, USA.
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH, USA.
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Fares Y, Sinzogan-Eyoum YC, Billoir P, Bogaert A, Armengol G, Alexandre K, Lammens J, Grall M, Levesque H, Benhamou Y, Miranda S. Systematic screening for a proximal DVT in COVID-19 hospitalized patients: Results of a comparative study. JOURNAL DE MEDECINE VASCULAIRE 2021; 46:163-170. [PMID: 34238510 PMCID: PMC8118667 DOI: 10.1016/j.jdmv.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic is associated with a high incidence of venous thromboembolism questioning the utility of a systematic screening for deep venous thrombosis (DVT) in hospitalised patients. METHODS In this prospective bicentric controlled study, 4-point ultrasound using a pocket device was used to screen for DVT, in patients with SARS-CoV-2 infection and controls admitted for acute medical illness not related to COVID-19 hospitalised in general ward, in order to assess the utility of a routine screening and to estimate the prevalence of VTE among those patients. RESULTS Between April and May 2020, 135 patients were screened, 69 in the COVID+ group and 66 in the control one. There was no significant difference in the rate of proximal DVT between the two groups (2.2% vs. 1.5%; P=0.52), despite the high rate of PE diagnosed among COVID-19 infected patients (10.1% vs. 1.5%, P=0.063). No isolated DVT was detected, 37.5% of PE was associated with DVT. Mortality (7.2% vs. 1.5%) was not different (P=0.21) between COVID-19 patients and controls. CONCLUSION The systematic screening for proximal DVT was not found to be relevant among COVID-19 patients hospitalized in general ward despite the increase of VTE among this population. Further studies are needed to confirm the hypothesis of a local pulmonary thrombosis which may lead to new therapeutic targets.
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Affiliation(s)
- Y Fares
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - Y C Sinzogan-Eyoum
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - P Billoir
- Department of vascular haemostasis, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - A Bogaert
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - G Armengol
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - K Alexandre
- Department of infectious diseases, Rouen university hospital, 76000 Rouen, France
| | - J Lammens
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - M Grall
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France; Department of medical intensive care unit, Rouen university hospital, 76000 Rouen, France
| | - H Levesque
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - Y Benhamou
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - S Miranda
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France.
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Ferrari F, Santos RD. Statins and COVID-19: To Suspend or Not to Suspend? That is the Question! Arq Bras Cardiol 2021; 116:147-152. [PMID: 33566980 PMCID: PMC8159509 DOI: 10.36660/abc.20200949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/10/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Filipe Ferrari
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil
| | - Raul D Santos
- Unidade Clínica de Lípides, Instituto do Coração (InCor), Hospital da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
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Berretta AA, Silveira MAD, Cóndor Capcha JM, De Jong D. Propolis and its potential against SARS-CoV-2 infection mechanisms and COVID-19 disease: Running title: Propolis against SARS-CoV-2 infection and COVID-19. Biomed Pharmacother 2020; 131:110622. [PMID: 32890967 PMCID: PMC7430291 DOI: 10.1016/j.biopha.2020.110622] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022] Open
Abstract
Propolis, a resinous material produced by honey bees from plant exudates, has long been used in traditional herbal medicine and is widely consumed as a health aid and immune system booster. The COVID-19 pandemic has renewed interest in propolis products worldwide; fortunately, various aspects of the SARS-CoV-2 infection mechanism are potential targets for propolis compounds. SARS-CoV-2 entry into host cells is characterized by viral spike protein interaction with cellular angiotensin-converting enzyme 2 (ACE2) and serine protease TMPRSS2. This mechanism involves PAK1 overexpression, which is a kinase that mediates coronavirus-induced lung inflammation, fibrosis, and immune system suppression. Propolis components have inhibitory effects on the ACE2, TMPRSS2 and PAK1 signaling pathways; in addition, antiviral activity has been proven in vitro and in vivo. In pre-clinical studies, propolis promoted immunoregulation of pro-inflammatory cytokines, including reduction in IL-6, IL-1 beta and TNF-α. This immunoregulation involves monocytes and macrophages, as well as Jak2/STAT3, NF-kB, and inflammasome pathways, reducing the risk of cytokine storm syndrome, a major mortality factor in advanced COVID-19 disease. Propolis has also shown promise as an aid in the treatment of various of the comorbidities that are particularly dangerous in COVID-19 patients, including respiratory diseases, hypertension, diabetes, and cancer. Standardized propolis products with consistent bioactive properties are now available. Given the current emergency caused by the COVID-19 pandemic and limited therapeutic options, propolis is presented as a promising and relevant therapeutic option that is safe, easy to administrate orally and is readily available as a natural supplement and functional food.
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Affiliation(s)
- Andresa Aparecida Berretta
- Research, Development and Innovation Department, Apis Flora Indl. Coml. Ltda, Ribeirão Preto, São Paulo, Brazil.
| | | | - José Manuel Cóndor Capcha
- Interdisciplinary Stem Cell Institute at Miller School of Medicine, University of Miami, Miami, Florida, United States.
| | - David De Jong
- Genetics Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Bertoletti L, Huisman MV. How can we better predict pulmonary blood clots in patients hospitalised for COVID-19? Eur Respir J 2020; 56:2003092. [PMID: 32907888 PMCID: PMC7487270 DOI: 10.1183/13993003.03092-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022]
Abstract
The emergence of coronavirus disease 2019 (COVID-19) has put pressure on health systems around the world [1, 2]. This coronavirus has also questioned much of our medical knowledge, with each day seeing the appearance of a new possible clinical expression of the virus [3]. Although its physiopathology is still poorly understood, the vascular tropism of the disease now seems to be a major pathway [4]. Recent studies highlight the development of a specific pulmonary vascular endothelialitis associated with thrombosis and angiogenesis [5]. D-dimer threshold at 2590 ng·mL−1 is able to predict pulmonary embolism in COVID-19 patients with clinical deterioration https://bit.ly/3kYObc3
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Affiliation(s)
- Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, CHU de St-Etienne, Saint-Etienne, France
- INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
- INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France
- F-CRIN INNOVTE network, Saint-Etienne, France
| | - Menno V. Huisman
- Dept of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
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Anthi A, Konstantonis D, Theodorakopoulou M, Apostolopoulou O, Karampela I, Konstantopoulou G, Patsilinakou S, Armaganidis A, Dimopoulos G. A Severe COVID-19 Case Complicated by Right Atrium Thrombus. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926915. [PMID: 32963216 PMCID: PMC7520871 DOI: 10.12659/ajcr.926915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Patient: Male, 73-year-old Final Diagnosis: Severe COVID-19 pneumonia complicated by right atrium thrombus Symptoms: Fever • dyspnea • cough Medication:— Clinical Procedure: — Specialty: Critical Care Medicine
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Affiliation(s)
- Anastasia Anthi
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Konstantonis
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Theodorakopoulou
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Apostolopoulou
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Karampela
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Konstantopoulou
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Patsilinakou
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Apostolos Armaganidis
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Dimopoulos
- 2nd Department of Critical Care, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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