Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences
Concerns for the long-term effects of COVID-19 infection have grown due to frequently reported persisting symptoms that can affect multiple systems for longer than 4 weeks after initial infection, a condition known as long-COVID-19 or post-acute COVID-19 syndrome (PACS). Even nonhospitalized survivo...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Current Research in Immunology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590255523000045 |
| _version_ | 1797422506843308032 |
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| author | Remy Martins-Gonçalves Eugenio D. Hottz Patricia T. Bozza |
| author_facet | Remy Martins-Gonçalves Eugenio D. Hottz Patricia T. Bozza |
| author_sort | Remy Martins-Gonçalves |
| collection | DOAJ |
| description | Concerns for the long-term effects of COVID-19 infection have grown due to frequently reported persisting symptoms that can affect multiple systems for longer than 4 weeks after initial infection, a condition known as long-COVID-19 or post-acute COVID-19 syndrome (PACS). Even nonhospitalized survivors have an elevated risk for the development of thromboinflammatory-associated events, such as ischemic stroke and heart failure, pulmonary embolism and deep vein thrombosis. Recent findings point to the persistence of many mechanisms of hypercoagulability identified to be associated with disease severity and mortality in the acute phase of the disease, such as sustained inflammation and endotheliopathy, accompanied by abnormal fibrin generation and impaired fibrinolysis. Platelets seem to be central to the sustained hypercoagulable state, displaying hyperreactivity to stimuli and increased adhesive capacity. Platelets also contribute to elevated levels of thromboinflammatory mediators and pro-coagulant extracellular vesicles in individuals with ongoing PACS. Despite new advances in the understanding of mechanisms sustaining thromboinflammation in PACS, little is known about what triggers this persistence. In this graphical review, we provide a schematic representation of the known mechanisms and consequences of persisting thromboinflammation in COVID-19 survivors and summarize the hypothesized triggers maintaining this prothrombotic state. |
| first_indexed | 2024-03-09T07:34:21Z |
| format | Article |
| id | doaj.art-80b9b451424d44118da41ac6c44d12d3 |
| institution | Directory Open Access Journal |
| issn | 2590-2555 |
| language | English |
| last_indexed | 2024-03-09T07:34:21Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Research in Immunology |
| spelling | doaj.art-80b9b451424d44118da41ac6c44d12d32023-12-03T05:42:48ZengElsevierCurrent Research in Immunology2590-25552023-01-014100058Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequencesRemy Martins-Gonçalves0Eugenio D. Hottz1Patricia T. Bozza2Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil; Programa de Imunologia e Inflamação, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Rio de Janeiro, BrazilLaboratório de Imunotrombose, Departamento de Bioquímica, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, BrazilLaboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil; Corresponding author.Concerns for the long-term effects of COVID-19 infection have grown due to frequently reported persisting symptoms that can affect multiple systems for longer than 4 weeks after initial infection, a condition known as long-COVID-19 or post-acute COVID-19 syndrome (PACS). Even nonhospitalized survivors have an elevated risk for the development of thromboinflammatory-associated events, such as ischemic stroke and heart failure, pulmonary embolism and deep vein thrombosis. Recent findings point to the persistence of many mechanisms of hypercoagulability identified to be associated with disease severity and mortality in the acute phase of the disease, such as sustained inflammation and endotheliopathy, accompanied by abnormal fibrin generation and impaired fibrinolysis. Platelets seem to be central to the sustained hypercoagulable state, displaying hyperreactivity to stimuli and increased adhesive capacity. Platelets also contribute to elevated levels of thromboinflammatory mediators and pro-coagulant extracellular vesicles in individuals with ongoing PACS. Despite new advances in the understanding of mechanisms sustaining thromboinflammation in PACS, little is known about what triggers this persistence. In this graphical review, we provide a schematic representation of the known mechanisms and consequences of persisting thromboinflammation in COVID-19 survivors and summarize the hypothesized triggers maintaining this prothrombotic state.http://www.sciencedirect.com/science/article/pii/S2590255523000045Post-acute COVID-19 syndrome (PACS)Platelet activationHypercoagulabilityThromboinflammation |
| spellingShingle | Remy Martins-Gonçalves Eugenio D. Hottz Patricia T. Bozza Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences Current Research in Immunology Post-acute COVID-19 syndrome (PACS) Platelet activation Hypercoagulability Thromboinflammation |
| title | Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences |
| title_full | Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences |
| title_fullStr | Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences |
| title_full_unstemmed | Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences |
| title_short | Acute to post-acute COVID-19 thromboinflammation persistence: Mechanisms and potential consequences |
| title_sort | acute to post acute covid 19 thromboinflammation persistence mechanisms and potential consequences |
| topic | Post-acute COVID-19 syndrome (PACS) Platelet activation Hypercoagulability Thromboinflammation |
| url | http://www.sciencedirect.com/science/article/pii/S2590255523000045 |
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