[HTML][HTML] Immunity, endothelial injury and complement-induced coagulopathy in COVID-19

L Perico, A Benigni, F Casiraghi, LFP Ng… - Nature Reviews …, 2021 - nature.com
L Perico, A Benigni, F Casiraghi, LFP Ng, L Renia, G Remuzzi
Nature Reviews Nephrology, 2021nature.com
In December 2019, a novel coronavirus was isolated from the respiratory epithelium of
patients with unexplained pneumonia in Wuhan, China. This pathogen, named severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a pathogenic condition that has
been termed coronavirus disease 2019 (COVID-19) and has reached pandemic proportions.
As of 17 September 2020, more than 30 million confirmed SARS-CoV-2 infections have
been reported in 204 different countries, claiming more than 1 million lives worldwide …
Abstract
In December 2019, a novel coronavirus was isolated from the respiratory epithelium of patients with unexplained pneumonia in Wuhan, China. This pathogen, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a pathogenic condition that has been termed coronavirus disease 2019 (COVID-19) and has reached pandemic proportions. As of 17 September 2020, more than 30 million confirmed SARS-CoV-2 infections have been reported in 204 different countries, claiming more than 1 million lives worldwide. Accumulating evidence suggests that SARS-CoV-2 infection can lead to a variety of clinical conditions, ranging from asymptomatic to life-threatening cases. In the early stages of the disease, most patients experience mild clinical symptoms, including a high fever and dry cough. However, 20% of patients rapidly progress to severe illness characterized by atypical interstitial bilateral pneumonia, acute respiratory distress syndrome and multiorgan dysfunction. Almost 10% of these critically ill patients subsequently die. Insights into the pathogenic mechanisms underlying SARS-CoV-2 infection and COVID-19 progression are emerging and highlight the critical role of the immunological hyper-response — characterized by widespread endothelial damage, complement-induced blood clotting and systemic microangiopathy — in disease exacerbation. These insights may aid the identification of new or existing therapeutic interventions to limit the progression of early disease and treat severe cases.
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