Fibrinolysis and COVID-19: A plasmin paradox.
Acute Lung Injury
Animals
Antifibrinolytic Agents
/ pharmacology
COVID-19
/ blood
Fibrin
/ metabolism
Fibrin Fibrinogen Degradation Products
/ metabolism
Fibrinolysin
/ metabolism
Fibrinolysis
/ drug effects
Humans
Immune System
Lung
/ metabolism
Necrosis
Prognosis
Thrombolytic Therapy
Tissue Plasminogen Activator
/ pharmacology
COVID-19 Drug Treatment
COVID-19
D-dimer
coronavirus
fibrinolysis
tranexamic acid
Journal
Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
30
04
2020
revised:
19
05
2020
accepted:
01
06
2020
pubmed:
17
6
2020
medline:
5
1
2021
entrez:
17
6
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic has provided many challenges in the field of thrombosis and hemostasis. Among these is a novel form of coagulopathy that includes exceptionally high levels of D-dimer. D-dimer is a marker of poor prognosis, but does this also imply a causal relationship? These spectacularly raised D-dimer levels may actually signify the failing attempt of the fibrinolytic system to remove fibrin and necrotic tissue from the lung parenchyma, being consumed or overwhelmed in the process. Indeed, recent studies suggest that increasing fibrinolytic activity might offer hope for patients with critical disease and severe respiratory failure. However, the fibrinolytic system can also be harnessed by coronavirus to promote infectivity and where antifibrinolytic measures would also seem appropriate. Hence, there is a clinical paradox where plasmin formation can be either deleterious or beneficial in COVID-19, but not at the same time. Hence, it all comes down to timing.
Identifiants
pubmed: 32543119
doi: 10.1111/jth.14960
pmc: PMC7323332
pii: S1538-7836(22)01659-2
doi:
Substances chimiques
Antifibrinolytic Agents
0
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Fibrin
9001-31-4
Tissue Plasminogen Activator
EC 3.4.21.68
Fibrinolysin
EC 3.4.21.7
Types de publication
Letter
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2118-2122Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 International Society on Thrombosis and Haemostasis.
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