Pathophysiological mechanisms involved in haemostatic and thromboinflammatory alterations developed by SARS-CoV-2 virus
Keywords:
COVID-19, Hemostasis, Blood Coagulation Disorders, Coronavirus Infections, Inflammation, ThrombosisAbstract
Introduction: the current COVID-2019 pandemic is the third man-made epidemic from coronavirus. The disease is diverse so there are elements not yet understood in infection, inflammation and hematological pathology. Objective: to describe the pathophysiological aspects involved in hemostatic and thromboinflammatory alterations in the face of infection by the SARS-CoV-2 virus. Method: a bibliographic review was carried out in the databases PubMed, SciElo, Medline, Science Direct, Medigraphic and Scopus, between July and August 2021. A total of 45 investigations were consulted between original articles, review articles and case presentations in Spanish and English languages. The articles with the greatest scientific impact that were related to the topic addressed and the most up-to-date were selected, out of a total of 30 bibliographic sources. Development: the immune system of the infected organism as part of its own response triggers a series of thrombotic events. These alterations are observed in almost all vascular beds. The SARS-Cov-2 virus binds to Angiotensin Converting Enzyme 2 and causes cell damage. Platelets have been shown to have changes in gene expression and their function in COVID-19. Conclusions: The pathophysiological mechanisms produced by SARS-CoV-2 are based on the increase in prothrombotic factors and the cytokine storm. The latter is produced by the body and generates a series of events translated into coagulopathy and thrombosis. Thromboinflammatory changes are more common and cause damage to various organs with fatal outcomes.
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1. Pérez Abreu MR, Gómez Tejeda JJ, Dieguez Guach RA. Características clínico-epidemiológicas de la COVID-19. Rev haban cienc méd [Internet]. 2020 [citado 18/8/2021]; 19(2):e3254. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3254/2505
2. Martí Sánchez D, Fernández Pascual C, Marschall AF. Aspectos cardiológicos relevantes en la infección COVID-19. RIECS [Internet]. 2020 [citado 18/8/2021]; 5(1):121-133. Disponible en: https://www.riecs.es/index.php/riecs/article/view/203
3. Páramo JA. Coagulopatía y trombosis: similitudes y diferencias entre coronavirus patogénicos. An. Stst. Santl. Navarr. [Internet]. 2020 [citado 20/8/2021]; 43(2):245-249. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272020000200014&lng=es&nrm=iso
4. Palomino Cabrera A, Cruz González M, Moreira Díaz LR, Almenares Sánchez L, Costa Felipe NC, Fajardo Borges C. Caracterización clínica y epidemiológica de pacientes confirmados con COVID-19 en un área de salud. 16 de Abril [Internet]. 2021 [19/8/2021]; 60 (281): e1248. Disponible en: http://www.rev16deabril.sld.cu/index.php/16_4/article/view/1248
5. Jiménez Franco LE, Gutiérrez Pérez DM, Montenegro Calderón T. Caracterización clínico-epidemiológica de los casos positivos de COVID-19 en Cienfuegos en el mes de marzo de 2021. 16 de Abril [Internet]. 2021 [20/8/2021]; 60 (280): e1206. Disponible en: http://www.rev16deabril.sld.cu/index.php/16_4/article/view/1206
6. Redacción MINSAP. Actualización epidemiológica. Nuevo coronavirus (2019-nCoV) [Internet]. 2021 [citado 6/04/2021]. Disponible en: https://salud.msp.gob.cu/parte-de-cierre-del-dia-15-de-agosto-a-las-12-de-la-noche-2/
7. Departamento de Vigilancia Epidemiológica. Registro de casos positivos de COVID-19 en Cienfuegos. Cienfuegos: Dirección Provincial de Salud; 2021.
8. Montoya Gil E, Lema Churo J, Rosero Caiza JA, et al. Hematología en época del COVID-19. RECIAMUC [Internet]. 2020 [citado 20/8/2021]; 4(3):288-297. Disponible en: https://reciamuc.com/index.php/RECIAMUC/article/view/523
9. Hanff TC, Mohareb A, Giri J, Cohen J, et al. Thrombosis in COVID-19. Am J Hematol. [Internet]. 2020 [ciado 19/8/2021]; 95:1578-1589. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32857878/
10. Iba T, Levy JH, Connors JM. The unique characteristics of COVID-19 coagulopathy. Critical Care [Internet]. 2020 [citado 20/8/2021]; 24:360-368. Disponible en: https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03077-0
11. Vayne C, Gruel Y, Pouplard C. Hemostasia: fisiología y principales pruebas de exploración. EMC [Internet]. 2021 [citado 20/8/2021]; 25(1):1-10. Disponible en: https://doi.org/10.1016/S1636-5410(21)44685-4
12. Grimaldo-Gómez FA. Fisiología de la hemostasia. Rev Mex Anestesiol [Internet]. 2017 [citado 20/8/2021]; 40(2):S398-S400. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=72683#:~:text=La%20hemostasia%20es%20un%20sistema,lesionado%20(con%20p%C3%A9rdida%20de%20la
13. Besaulduch J. Alteraciones hematológicas y COVID-19. Medicina Balear [Internet]. 2020 [citado 19/8/2021]; 35(4):69-73. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7683234
14. Gómez-Gómez B, Rodríguez-Weber FL, Díaz-Greene EJ. Fisiología plaquetaria, agregometría plaquetaria y su utilidad clínica. Med Int Méx [Internet]. 2018 [citado 19/8/2021]; 34(2):244-263. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0186-48662018000200007&lng=es&nrm=iso
15. González-Villalvaa A, de la Peña-Díaz A, Rojas-Lemusa M. Fisiología de la hemostasia y su alteración por la coagulopatía en COVID-19. Rev Facult Med UNAM [Internet]. 2020 [citado 17/8/2021]; 63(5):45-57. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026-17422020000500045&lng=es&nrm=iso
16. Villa Palacio MI, López Henao E. Alteraciones hematológicas en COVID-19. NOVA [Internet]. 2020 [citado 20/8/2021]; 16(35):77-79. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1794-24702020000300075&lng=en&nrm=iso
17. Carrillo-Esper R, Melgar-Bieberach RE, Jacinto-Flores SA, et al. Alteraciones de la coagulación en la COVID 19. Cir Cir [Internet]. 2020 [citado 18/8/2021]; 88(6):789-793. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33254192/
18. Wang J, Saguner A, An J. Dysfunctional Coagulation in COVID-19: From Cell to Bedside. Adv Ther [Internet]. 2020 [citado 18/8/2021]; 37(7):3033-3099. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32504450/
19. Parra-Izquierdo V, Flórez-Sarmiento C, Romero-Sánchez C. Inducción de “tormenta de citocinas” en pacientes infectados con SARS- CoV-2 y desarrollo de COVID-19. ¿Tiene el tracto gastrointestinal alguna relación en la gravedad? Rev Colomb Gastroenterol [Internet]. 2020 [citado 20/8/2021]; 35(1):21-29. Disponible en: https://www.redalyc.org/articulo.oa?id=337765096005
20. Hashemieh M. Hematologic Parameters of COVID – 19: A Review on Alteration of Hematologic Laboratory Findings. Int J Pedriatr [Internet]. 2020 [citado 21/8/2021]; 8(9):11921-11929. Disponible en: https://iranjournals.nlai.ir/handle/123456789/318588
21. Singh B, Aly R, Kaur P. COVID-19 Infection and Arterial Thrombosis: Report of Three Cases. Annals of Vascular Surgery [Internet]. 2021 [citado 22/8/2021]; 70:315-317. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462876/
22. Fulgencio-Barbarin J, Calleja-Algarra A, Morales-Raya C. Trombosis sistémica producida por COVID 19. Med Clin (Barc) [Internet]. 2020 [citado 18/8/2021]; 155(6):278. Disponible en: https://www.elsevier.es/es-revista-medicina-clinica-2-articulo-trombosis-sistemica-producida-por-covid-19-S0025775320303523
23. Llau JV, Ferrandis R, Sierra P, et al. Recomendaciones del consenso SEDAR-SEMICYUC sobre el manejo de las alteraciones de la hemostasia en los pacientes graves con infección por COVID 19. Res Esp Anestesiol Reanim [Internet]. 2020 [citado 21/8/2021]; 67(7):391-399. Disponible en: https://www.medintensiva.org/es-consenso-sedar-semicyuc-sobre-el-manejo-avance-S0210569120302722
24. Zalba Marcos S, Antelo ML, Galbete A, et al. Infección y trombosis asociada a la COVID 19: posible papel del grupo sanguíneo ABO. Med Clin (Barc) [Internet]. 2020 [citado 19/8/2021]; 155(8):340-343. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346773/
25. Fernández Lozanoa I, Cequier Fillatb A, Expósito Garcíac V. Mejorar la prevención de la trombosis y las complicaciones cardiovasculares durante la pandemia de COVID-19. Rev Esp Cardiol Supl [Internet]. 2021 [citado 20/8/2021]; 21(A):1-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8320271/
26. Rozado J, Ayestaa A, Morísa C. Fisiopatología de la enfermedad cardiovascular en pacientes con COVID-19. Isquemia, trombosis y disfunción cardiaca. Rev Esp Cardiol Supl [Internet]. 2020 [citado 18/8/2021]; 20(E):2-8. Disponible en: https://www.revespcardiol.org/es-fisiopatologia-enfermedad-cardiovascular-pacientes-con-articulo-S1131358720300285
27. Gutiérrez-Zevallos JD, Guarniz-Huamán DA, Sánchez-Landers M. Trombosis venosa cerebral y COVID-19: ¿Asesino silencioso durante la pandemia? Rev Neuropsiquiatr [Internet]. 2021 [citado 19/8/2021]; 81(4):19-24. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S0034-85972021000100019&lng=es&nrm=iso
28. Martín-Rojas, Pérez-Rus G, Delgado-Pinos VE. COVID-19 coagulopathy: An in-depth analysis of the coagulation system. Eur J Haematol [Internet]. 2020 [citado 20/8/2021]; 105(6):741-750. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32749010/
29. Mousavi SA, Rad S, Rostam T. Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. Hematology [Internet]. 2020 [citado 19/8/2021]; 25(1):383-388. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33124971/#:~:text=Hematologic%20predictors%20of%20a%20fatal,inflammatory%20indicators%20in%20the%20blood.
30. Jara González FE, Jiménez Alulima GF, Sananay Auquilla EL, et al. Hipercoagulabilidad, trombosis intravascular y trombocitosis asociada al COVID-19. Reporte de un caso. Rev Bionatura [Internet]. 2020 [citado 17/8/2021]; 5(2):1138-1141. Disponible en: https://www.revistabionatura.com/files/2020.05.02.11.pdf
31. Yang Fei MS, Ning Tang MPH, Hefei Liu BS, et al. Coagulation Dysfunction. Arch Pathol Lab Med [Internet]. 2020 [citado 20/8/2021]; 144(10):1223-1229. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32551814/
32. Hincapie-Hincapie A, Ballén-Pinilla D, Amuruz-Arancibia J, et al. Trombosis de senos venosos cerebrales una manifestación extrapulmonar de COVID-19: Reporte de caso. Infectio [Internet]. 2021 [citado 15/8/2021]; 25(4):289-292. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_isoref&pid=S0123-93922021000400289&lng=en&tlng=es
33. Cheruiyot I, Kipkorir V, Ngure B. Arterial Thrombosis in Coronavirus Disease 2019 Patients: A Rapid Systematic Review. Annals of Vascular Surgery [Internet]. 2021 [citado 20/8/2021]; 70:273-281. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453204/
34. McFadyen J, Stevens H, Peter K. The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications. Circulation Research [Internet]. 2020 [citado 18/8/2021]; 127:571-587. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32586214/
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