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Cited by 10COVID-19 Clinical Research StudiesCOVID-19 and healthcare impactsLong-Term Effects of COVID-19

From cellular function to global impact: the vascular perspective on COVID-19

Open access
Strauss, Shira A., Seo, Chanhee, Carrier, Marc, Jetty, Prasad·2021·Canadian Journal of Surgery
DOI 10.1503/cjs.023820PMC PMC8327988
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Abstract

Since COVID-19 was declared a pandemic a year ago, our understanding of its effects on the vascular system has slowly evolved. At the cellular level, SARS-CoV-2 - the virus that causes COVID-19 - accesses the vascular endothelium through the angiotensin-converting enzyme 2 (ACE-2) receptor and induces proinflammatory and prothrombotic responses. At the clinical level, these pathways lead to thromboembolic events that affect the pulmonary, extracranial, mesenteric, and lower extremity vessels. At the population level, the presence of vascular risk factors predisposes individuals to more severe forms of COVID-19, whereas the absence of vascular risk factors does not spare patients with COVID-19 from unprecedented rates of stroke, pulmonary embolism and acute limb ischemia. Finally, at the community and global level, the fear of COVID-19, measures taken to limit the spread of SARS-CoV-2 and reallocation of limited hospital resources have led to delayed presentations of severe forms of ischemia, surgery cancellations and missed opportunities for limb salvage. The purpose of this narrative review is to present some of the data on COVID-19, from cellular mechanisms to clinical manifestations, and discuss its impact on the local and global surgical communities from a vascular perspective.

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  • Pre-existing cardiovascular diseases were observed in the Strauss et al. systematic review, which found evidence of a relationship between venous thromboembolism cases and these conditions.

    “Pre-existing cardiovascular diseases were also observed in the Strauss et al.50 systematic review, which found evidence of a relationship between venous thromboembolism cases and these conditions.”

    From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as Strauss et al.50

    The Vascular patients with COVID-19 section (page unavailable) reports that pre-existing cardiovascular disease and related risk factors were associated with worse COVID-19 outcomes. The Venous thromboembolism section (page unavailable) discusses VTE in COVID-19, but does not establish a relationship between VTE cases and pre-existing cardiovascular disease. It also identifies the VTE systematic review as a separate Swiss review, not a systematic review by Strauss et al. (LLM, conf=0.84)

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  • Other studies have demonstrated a relationship between SMVT and previous cardiovascular disease.

    “Other studies had already demonstrated the relationship between SMVT and previous cardiovascular disease (Strauss et al.50 and Guillet et al.51).”

    From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as Strauss et al.50

    The Venous thromboembolism section discusses VTE in patients with COVID-19, and the Peripheral arterial thromboembolism section mentions a superior mesenteric artery occlusion. Neither addresses a relationship between SMVT and previous cardiovascular disease. Searches for SMVT and mesenteric venous thrombosis did not find a passage establishing that relationship in our copy. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Strauss, S. A., Seo, C., Carrier, M., & Jetty, P.
Affiliations
University of Ottawa (CA)
Corresponding author
Strauss, Shira A.
ORCID
Venue
Canadian Journal of Surgery
Publisher
CMA Joule Inc.
Published
2021-06
Volume
64
Issue
3
Pages
E289-E297
ISSN
  • 0008-428X (ISSN-L)
  • 1488-2310
DOI
10.1503/cjs.023820
PMC
PMC8327988
OpenAlex
W3160227856
Cited by
10
References
2
Citations by year
2025: 3 · 2023: 2 · 2022: 3 · 2021: 1
FWCI
0.18
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Canadian Journal of Surgery (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Bristol-Myers Squibb
  • Pfizer
  • Sanofi
  • LEO Pharma
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Keywords
COVID-19 pandemic, SARS-CoV-2, vascular endothelium, ACE2 receptor, thrombosis, thromboembolism, stroke, pulmonary embolism, acute limb ischemia, vascular risk factors, limb salvage, pandemic impact on surgery
MeSH terms
COVID-19, SARS-CoV-2, Cells, Humans, Vascular Diseases, Elective Surgical Procedures, Internationality

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