Blood clots in COVID-19 patients: Simplifying the curious mystery.
Blood clots in COVID-19 patients: Simplifying the curious mystery.
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DOI：
10.1016/j.mehy.2020.110371
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发表时间：
2021-01
影响因子：
4.7
通讯作者：
Kumar P
中科院分区：
文献类型：
--
作者：
Biswas S;Thakur V;Kaur P;Khan A;Kulshrestha S;Kumar P
众所周知，血液凝固的普遍现象在外部细胞/组织损伤中具有保护作用。然而，COVID-19患者出现不寻常的血栓形成是真实的问题。刺突糖蛋白与宿主细胞表面存在的ACE 2受体的相互作用介导SARS-CoV-2的进入，引起COVID-19感染。SARS-CoV-2发病机制的新临床发现每天都在出现，其中一个谜团是COVID-19患者的各种组织和器官中形成了神秘的血块，这需要引起高度重视。为了解决这个问题，我们假设，血管内皮细胞中的高ACE 2表达促进了SARS-CoV-2使用刺突蛋白的高亲和力结合，导致血管壁内的感染和内部损伤。这种病毒相关损伤可能直接/间接启动凝血和凝血级联的激活，形成内部血凝块。然而，这些凝块的存在是不希望的，因为它们是血栓形成的原因，并且需要用抗血栓形成干预来治疗。
The universal phenomenon of blood clotting is well known to be protective in external cellular/ tissue injury. However, the emergence of unusual thrombotic presentations in COVID-19 patients is the real concern. Interaction of the spike glycoprotein with ACE2 receptor present in the host cell surface mediates the entry of SARS-CoV-2 causing COVID-19 infection. New clinical findings of SARS-CoV-2 pathogenesis are coming out every day, and one such mystery is the formation of mysterious blood clots in the various tissues and organs of COVID-19 patients, which needs critical attention. To address this issue, we hypothesis that, high ACE2 expression in the endothelium of blood vessels facilitates the high-affinity binding of SARS-CoV-2 using spike protein, causing infection and internal injury inside the vascular wall of blood vessels. This viral associated injury may directly/indirectly initiate activation of coagulation and clotting cascades forming internal blood clots. However, the presence of these clots is undesirable as they are responsible for thrombosis and need to be treated with anti-thrombotic intervention.
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