COVID-19 associated thromboinflammation of renal capillary: Potential mechanisms and treatment

Chen，Xiaojing1,2; Yu，Chengyuan3; Jing，Haijiao2; Wang，Chunxu2; Zhao，Xinyi2; Zhang，Jinming2; Zhang，Shuoqi2; Liu，Huan2; Xie，Rujuan1; Shi，Jialan2,4

2021

American Journal of Translational Research   影响因子和分区

1943-8141

Coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic disease with high morbidity and mortality. Inflammatory and thrombosis are its main manifestations. As an important organ of hemofiltration metabolism, the kidney is prone to blockage and destruction when filter high inflammatory and high viscous blood of COVID-19, resulting in the loss of a large amount of protein, aggravating blood concentration, and then worsening COVID-19 hypercoagulability, which may explain the phenomenon of erythrocytes aggregation blocking the capillary lumen and the main reason why the kidney has become the second largest involvement organs. Therefore, this review discusses the effects of pathophysiological mechanisms such as inflammatory storm, endothelial injury, phosphatidylserine expression, extracellular traps release on renal capillary thrombosis caused by COVID-19 infection. Meanwhile, in view of the above mechanisms, we put forward the potential targets of antithrombotic therapy, and graded management of patients, reasonable use of drugs according to the severity of the disease and the choice of time. And we support the view of prevention of thrombus before admission, continuous anticoagulation and drug choice after discharge. It is suggested that the symptomatic and supportive treatment of renal disease in critically ill patients should be combined with the concept of antithrombotic therapy. The ultimate goal is to reduce the occurrence and development of kidney disease, provide direction for the current management of COVID-19 with kidney disease, and reduce the mortality of COVID-19.

Antithrombotic therapy COVID-19 Graded management Inflammation Renal capillary thrombosis

英语

其他

2-s2.0-85099389284

Scopus

1.Department of Nephrology,The First Hospital of Harbin,Harbin Medical University,China
2.Department of Hematology,The First Hospital of Harbin,Harbin Medical University,China
3.Department of Geriatric,The Second Clinical Medical College,Jinan University,The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen, Guangdong,518020,China
4.Departments of Research and Medicine,VA Boston Healthcare System,Brigham and Women's Hospital,Harvard Medical School,Boston,United States

Chen，Xiaojing,Yu，Chengyuan,Jing，Haijiao,et al. COVID-19 associated thromboinflammation of renal capillary: Potential mechanisms and treatment[J]. American Journal of Translational Research,2021,12(12):7640-7656.

Chen，Xiaojing.,Yu，Chengyuan.,Jing，Haijiao.,Wang，Chunxu.,Zhao，Xinyi.,...&Shi，Jialan.(2021).COVID-19 associated thromboinflammation of renal capillary: Potential mechanisms and treatment.American Journal of Translational Research,12(12),7640-7656.

Chen，Xiaojing,et al."COVID-19 associated thromboinflammation of renal capillary: Potential mechanisms and treatment".American Journal of Translational Research 12.12(2021):7640-7656.