COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation

de Maistre, Emmanuel; Savard, Philippe; Guinot, Pierre-Gregoire

doi:10.3390/jcm12237245

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COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation

by

Emmanuel de Maistre

^1,*

,

Philippe Savard

¹

and

Pierre-Gregoire Guinot

²

¹

Haemostais Unit, Dijon University Hospital, F-21000 Dijon, France

²

Department of Anesthesiology and Intensive Care, Dijon University Hospital, F-21000 Dijon, France

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2023, 12(23), 7245; https://doi.org/10.3390/jcm12237245

Submission received: 30 September 2023 / Revised: 10 November 2023 / Accepted: 16 November 2023 / Published: 23 November 2023

(This article belongs to the Special Issue Multidisciplinary Approach to Severe COVID Infection)

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Abstract

COVID-19, caused by the SARS-CoV-2 virus, has revealed a complex interplay between inflammation and coagulation, leading to the emergence of the concept of thrombo-inflammation. This concept recognizes that COVID-19 is not solely a respiratory illness, but a systemic disease with significant vascular and hematological components. COVID-19 is associated with an unusual prothrombotic state, with intense endothelial activation leading to vasculopathy, cytokine storm, complement system activation and a hypercoagulability state (the activation of platelets and the coagulation cascade, impaired fibrinolysis). The aim of this review is to discuss the different pathological pathways described in COVID-19 that lead to thromboembolic events. Widespread vaccination and post-COVID-19 immunization allows control over the severity of this pandemic. A better understanding of the pathophysiology of COVID-19 can improve the management of frail patients who are hospitalized in intensive care units.

Keywords: COVID-19; cytokine storm; complement activation; vasculopathy; hypercoagulopathy; platelet activation; anticoagulation treatment

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MDPI and ACS Style

de Maistre, E.; Savard, P.; Guinot, P.-G. COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation. J. Clin. Med. 2023, 12, 7245. https://doi.org/10.3390/jcm12237245

AMA Style

de Maistre E, Savard P, Guinot P-G. COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation. Journal of Clinical Medicine. 2023; 12(23):7245. https://doi.org/10.3390/jcm12237245

Chicago/Turabian Style

de Maistre, Emmanuel, Philippe Savard, and Pierre-Gregoire Guinot. 2023. "COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation" Journal of Clinical Medicine 12, no. 23: 7245. https://doi.org/10.3390/jcm12237245

APA Style

de Maistre, E., Savard, P., & Guinot, P.-G. (2023). COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation. Journal of Clinical Medicine, 12(23), 7245. https://doi.org/10.3390/jcm12237245

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation

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