Abstract
The SARS-CoV-2 virus has a tropism for endotheliocytes, and it causes various clinical manifestations. Systemic inflammation of the endothelium leads to blood clotting in the vessels. In the literature, about a hundred cases of systemic vasculitis are described as manifestations of COVID-19. These cases were manifested by ischemic and necrotic changes in the limbs/fingers, nervous system, intestines, and retina, skin rashes, as well as myocardial infarctions and brain infarctions/strokes. The most frequent vascular manifestation of COVID-19 is Kawasaki-like syndrome. It is illustrated here by a clinical case.
References
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15. Zazoulina J, Cheung CC, Hurlburt A, Chahal D, Wong S. A case of adult-onset Kawasaki Disease shock syndrome complicated by coronary aneurysms. CJC Open. 2019;1:206-20.
2. Klok FA, Kruip MJHA, van der Meer NJM [et al.] Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis. Thromb Res. 2020;S0049-3848(20):30157-30162.
3. Evans РС, Rainger GE, Mason JC, et al. Endothelial dysfunction in COVID-19: a position paper of the ESC Working Group for Atherosclerosis and Vascular Biology, and the ESC Council of Basic Cardiovascular Science. Cardiovasc Res. 2020;cvaa 230. doi: 10.1093/cvr/cvaa230.
4. Iba T, Connors JM, Levy JH. The coagulopathy, endotheliopathy, and vasculitis of COVID-19Inflamm Res. 2020;69(12):1181-1189. doi: 10.1007/s00011-020-01401-6.
5. Becker RC. COVID-19 update: Covid-19-associated coagulopathy. J Thromb Thrombolysis. 2020;50:54-67.
6. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395:1417-1418.
7. Menter T, Haslbauer JD, Nienhold R, Savic S, Hopfer H, et al. Post-mortem examination of COVID-19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathology. 2020.
8. Sharma A, Garcia G, Arumugaswami V, Svendsen CN. Human iPSC-derived cardiomyocytes are susceptible to SARS-CoV-2 infection. BioRxiv. 2020. doi: 10.1101/2020.04.21.051912.
9. Colling ME, Kanthi Y. COVID-19-associated coagulopathy: An exploration of mechanisms Vasc Med. 2020;25(5):471-478. doi: 10.1177/1358863X20932640.
10. Verdoni L, Mazza A, Gervasoni A [et al.] An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395:1771-1778.
11. Cordoro KM, Reynolds SD, Wattier R, McCalmont TH. Clustered cases of acral perniosis: clinical features, histopathology, and relationship to COVID-19. Pediatr Dermatol. 2020;37:419-423.
12. Kanitakis J, Lesort C, Danset M, Jullien D. Chilblain-like acral lesions during the COVID-19 pandemic («COVID TOES»): histologic, immunofluorescence and immunohistochemical study of 17 cases. J Am. Acad. Dermatol. 2020. doi:10.1016/j.jaad. 2020.05.145.
13. Toubiana J, Poirault C, Corsia A [et al.]. Kawasaki-like multisystem inflammatory syndrome in children during the Covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020;369:m2094.
14. Rowley AH. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nat Rev Immunol. 2020; https://doi.org/10.1038/s41577-020-0367-5
15. Zazoulina J, Cheung CC, Hurlburt A, Chahal D, Wong S. A case of adult-onset Kawasaki Disease shock syndrome complicated by coronary aneurysms. CJC Open. 2019;1:206-20.
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