Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches.
Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches.
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DOI：
10.1172/jci161167
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发表时间：
2022-08-01
期刊：
影响因子：
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通讯作者：
Laurence J
中科院分区：
文献类型：
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作者：
Ahamed J;Laurence J
SARS-CoV-2感染者可能会出现多器官系统疾病，称为“长期COVID”或SARS-CoV-2感染后急性后遗症（PASC）。没有标准的治疗方法，病理生理学尚不清楚，发病率因临床表型而异。急性COVID-19与PASC中不太突出的全身性炎症、高凝状态和合并症的生物标志物相关。大血管血栓形成是急性COVID-19的标志，在PASC中不太常见。出生时女性与急性COVID-19进展风险降低相关，但与PASC风险增加相关。与隐匿性SARS-CoV-2组织储库相关的持续性微血管内皮病变与PASC病理学有关。也可能涉及自身抗体、局部炎症和潜伏病原体的再激活，可能导致微血管血栓形成，如多个PASC组织中所记录的。诊断检测照亮可能的治疗目标进行了讨论。
SARS-CoV-2–infected individuals may suffer a multi–organ system disorder known as “long COVID” or post-acute sequelae of SARS-CoV-2 infection (PASC). There are no standard treatments, the pathophysiology is unknown, and incidence varies by clinical phenotype. Acute COVID-19 correlates with biomarkers of systemic inflammation, hypercoagulability, and comorbidities that are less prominent in PASC. Macrovessel thrombosis, a hallmark of acute COVID-19, is less frequent in PASC. Female sex at birth is associated with reduced risk for acute COVID-19 progression, but with increased risk of PASC. Persistent microvascular endotheliopathy associated with cryptic SARS-CoV-2 tissue reservoirs has been implicated in PASC pathology. Autoantibodies, localized inflammation, and reactivation of latent pathogens may also be involved, potentially leading to microvascular thrombosis, as documented in multiple PASC tissues. Diagnostic assays illuminating possible therapeutic targets are discussed.