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Cited by 517

The DOI matches its Crossref record; 92 of the 92 references it cites were found in a registry or an index.

The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection

Open access
Pons, Stéphanie, Fodil, Sofiane, Azoulay, Elie, Zafrani, Lara·2020·Critical Care

Abstract

In severe SARS-CoV-2 infections, emerging data including recent histopathological studies have emphasized the crucial role of endothelial cells (ECs) in vascular dysfunction, immunothrombosis, and inflammation. Histopathological studies have evidenced direct viral infection of ECs, endotheliitis with diffuse endothelial inflammation, and micro- and macrovascular thrombosis both in the venous and arterial circulations. Venous thrombotic events, particularly pulmonary embolism, with elevated D-dimer and coagulation activation are highly prevalent in COVID-19 patients. The pro-inflammatory cytokine storm, with elevated levels of interleukin-6 (IL-6), IL-2 receptor, and tumor necrosis factor-α, could also participate in endothelial dysfunction and leukocyte recruitment in the microvasculature. COVID-19-induced endotheliitis may explain the systemic impaired microcirculatory function in different organs in COVID-19 patients. Ongoing trials directly and indirectly target COVID-19-related endothelial dysfunctions: i.e., a virus-cell entry using recombinant angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS-2) blockade, coagulation activation, and immunomodulatory therapies, such as anti-IL-6 strategies. Studies focusing on endothelial dysfunction in COVID-19 patients are warranted as to decipher their precise role in severe SARS-CoV-2 infection and organ dysfunction and to identify targets for further interventions.

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Metadata

Authors
Pons, S., Fodil, S., Azoulay, E., & Zafrani, L.
Venue
Critical Care
Published
2020-06-16
Volume
24
Issue
1
Pages
353-353
ISSN
1364-8535 (ISSN-L)
OpenAlex
W3035584582
Cited by
517
References
92
FWCI
13.19
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection. https://app.cochat.ai/papers/10.1186/s13054-020-03062-7
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Pons, S., Fodil, S., Azoulay, E., & Zafrani, L. (2020). The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection. Critical Care. https://doi.org/10.1186/s13054-020-03062-7

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