Anatomical and Pathological Observation and Analysis of SARS and COVID-19: Microthrombosis Is the Main Cause of Death

doi:10.1186/s12575-021-00142-y

科研成果详情

题名	Anatomical and Pathological Observation and Analysis of SARS and COVID-19: Microthrombosis Is the Main Cause of Death
作者	Chen, Wenjing 1; Pan, Jing Ye 1,2,3
发表日期	2021-01-20
发表期刊	BIOLOGICAL PROCEDURES ONLINE 影响因子和分区
语种	英语
原始文献类型	Review
关键词	SARS-CoV-2 COVID-19 Microcirculation Dysfunction Autopsy Pathology Diffuse Alveolar Damage Disseminated Intravascular Coagulation
其他关键词	CYTOKINES
摘要	The spread of the coronavirus (SARS-CoV-2, COVID-19 for short) has caused a large number of deaths around the world. We summarized the data reported in the past few months and emphasized that the main causes of death of COVID-19 patients are DAD (Diffuse Alveolar Damage) and DIC (Disseminated intravascular coagulation). Microthrombosis is a prominent clinical feature of COVID-19, and 91.3% of dead patients had microthrombosis. Endothelial damage caused by SARS-CoV-2 cell invasion and subsequent host response disorders involving inflammation and coagulation pathways play a key role in the progression of severe COVID-19. Microvascular thrombosis may lead to microcirculation disorders and multiple organ failure lead to death. The characteristic pathological changes of DAD include alveolar epithelial and vascular endothelial injury, increased alveolar membrane permeability, large numbers of neutrophil infiltration, alveolar hyaline membrane formation, and hypoxemia and respiratory distress as the main clinical manifestations. DAD leads to ARDS in COVID-19 patients. DIC is a syndrome characterized by the activation of systemic intravascular coagulation, which leads to extensive fibrin deposition in the blood. Its occurrence and development begin with the expression of tissue factor and interact with physiological anticoagulation pathways. The down-regulation of fibrin and the impaired fibrinolysis together lead to extensive fibrin deposition. DIC is described as a decrease in the number of platelets and an increase in fibrin degradation products, such as D-dimer and low fibrinogen. The formation of microthrombus leads to the disturbance of microcirculation, which in turn leads to the death of the patient. However, the best prevention and treatment of COVID-19 microthrombosis is still uncertain. This review discusses the latest findings of basic and clinical research on COVID-19-related microthrombosis, and then we proposed the theory of microcirculation perfusion bundle therapy to explore effective methods for preventing and treating COVID-19-related microthrombosis. Further research is urgently needed to clarify how SARS-CoV-2 infection causes thrombotic complications, and how it affects the course and severity of the disease. To cultivate a more comprehensive understanding of the underlying mechanism of this disease. Raise awareness of the importance of preventing and treating microthrombosis in patients with COVID-19.
资助项目	National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81671968]; Medical Innovation Discipline of Zhejiang Province (Critical Care Medicine, Y2015); Zhejiang Province [WKJ-ZJ-1909]; Ministry of Science and Technology [WKJ-ZJ-1909]
出版者	BMC
出版地	LONDON
ISSN	1480-9222
EISSN	1480-9222
卷号	23 期号:1 页码:4
DOI	10.1186/s12575-021-00142-y
页数	12
WOS类目	Biochemical Research Methods
WOS研究方向	Biochemistry & Molecular Biology
WOS记录号	WOS:000609178400001
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	33472576
PMC记录号	PMC7816139
SCOPUSEID	2-s2.0-85099662309
ESI高被引论文	2021-09 ; 2021-11 ; 2022-01 ; 2022-03 ; 2022-05 ; 2022-07 ; 2022-09 ; 2022-11 ; 2023-01
通讯作者地址	[Pan, Jing Ye]School of the First Clinical Medical Sciences,Wenzhou Medical University,Wenzhou,China
Scopus学科分类	Biochemistry, Genetics and Molecular Biology (all)
引用统计	被引频次：36[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/16338
专题	第一临床医学院（信息与工程学院）、附属第一医院附属第一医院_重症医学科（ICU）
通讯作者	Pan, Jing Ye
作者单位	1.School of the First Clinical Medical Sciences,Wenzhou Medical University,Wenzhou,China; 2.Department of Intensive Care Unit,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 3.Wenzhou Key Laboratory of Critical Care and Artificial Intelligence,Wenzhou,China
第一作者单位	温州医科大学
通讯作者单位	温州医科大学
第一作者的第一单位	温州医科大学
推荐引用方式 GB/T 7714	Chen, Wenjing,Pan, Jing Ye. Anatomical and Pathological Observation and Analysis of SARS and COVID-19: Microthrombosis Is the Main Cause of Death[J]. BIOLOGICAL PROCEDURES ONLINE,2021,23(1):4.
APA	Chen, Wenjing, & Pan, Jing Ye. (2021). Anatomical and Pathological Observation and Analysis of SARS and COVID-19: Microthrombosis Is the Main Cause of Death. BIOLOGICAL PROCEDURES ONLINE, 23(1), 4.
MLA	Chen, Wenjing,et al."Anatomical and Pathological Observation and Analysis of SARS and COVID-19: Microthrombosis Is the Main Cause of Death".BIOLOGICAL PROCEDURES ONLINE 23.1(2021):4.