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dc.contributor.authorKamel, Mohamed Hassan
dc.contributor.authorYin, Wenqing
dc.contributor.authorZavaro, Chris
dc.contributor.authorFrancis, Jean M.
dc.contributor.authorChitalia, Vipul C.
dc.date.accessioned2020-11-05T19:20:47Z
dc.date.available2020-11-05T19:20:47Z
dc.date.issued2020-10
dc.date.submitted2020-09
dc.identifier.issn2073-4409
dc.identifier.urihttps://hdl.handle.net/1721.1/128363
dc.description.abstractCOVID-19 infection has protean systemic manifestations. Experience from previous coronavirus outbreaks, including the current SARS-CoV-2, has shown an augmented risk of thrombosis of both macrovasculature and microvasculature. The former involves both arterial and venous beds manifesting as stroke, acute coronary syndrome and venous thromboembolic events. The microvascular thrombosis is an underappreciated complication of SARS-CoV-2 infection with profound implications on the development of multisystem organ failure. The telltale signs of perpetual on-going coagulation and fibrinolytic cascades underscore the presence of diffuse endothelial damage in the patients with COVID-19. These parameters serve as strong predictors of mortality. While summarizing the alterations of various components of thrombosis in patients with COVID-19, this review points to the emerging evidence that implicates the prominent role of the extrinsic coagulation cascade in COVID-19-related coagulopathy. These mechanisms are triggered by widespread endothelial cell damage (endotheliopathy), the dominant driver of macro- and micro-vascular thrombosis in these patients. We also summarize other mediators of thrombosis, clinically relevant nuances such as the occurrence of thromboembolic events despite thromboprophylaxis (breakthrough thrombosis), current understanding of systemic anticoagulation therapy and its risk–benefit ratio. We conclude by emphasizing a need to probe COVID-19-specific mechanisms of thrombosis to develop better risk markers and safer therapeutic targets.en_US
dc.description.sponsorshipNIH (Grant R01 HL132325)en_US
dc.publisherMDPI AGen_US
dc.relation.isversionofhttp://dx.doi.org/10.3390/cells9112392en_US
dc.rightsCreative Commons Attribution 4.0 International licenseen_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.sourceMDPIen_US
dc.titleHyperthrombotic Milieu in COVID-19 Patientsen_US
dc.typeArticleen_US
dc.identifier.citationKamel, Mohamed Hassan et al. "Hyperthrombotic Milieu in COVID-19 Patients." Cells 9, 11 (October 2020): 2392 © 2020 The Authorsen_US
dc.contributor.departmentMassachusetts Institute of Technology. Institute for Medical Engineering & Scienceen_US
dc.contributor.departmentHarvard University--MIT Division of Health Sciences and Technologyen_US
dc.relation.journalCellsen_US
dc.eprint.versionFinal published versionen_US
dc.type.urihttp://purl.org/eprint/type/JournalArticleen_US
eprint.statushttp://purl.org/eprint/status/PeerRevieweden_US
dspace.date.submission2020-11-05T14:48:53Z
mit.journal.volume9en_US
mit.journal.issue11en_US
mit.licensePUBLISHER_CC
mit.metadata.statusComplete


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