ReviewEmerging microbes & infections2020
Kawasaki-like diseases and thrombotic coagulopathy in COVID-19: delayed over-activation of the STING pathway?
Review in Emerging microbes & infections, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
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Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Systemic inflammatory syndrome in COVID-19-SISCoV study: systematic review and meta-analysis.Pediatric research · 2022Pooled it
- Artificial platelets suppressing deep vein thrombosis via competitive adhesion.Bioactive materials · 2026Article
- Research progress on the mechanisms of cGAS-STING signaling in immune cell infiltration associated with vascular remodeling.Journal of translational medicine · 2025Review
- Pattern Recognition Receptors (PRRs) Expression and Activation in COVID-19 and Long COVID: From SARS-CoV-2 Escape Mechanisms to Emerging PRR-Targeted Immunotherapies.Microorganisms · 2025Review
- Article
- Nanoparticle-Based Strategies to Enhance the Efficacy of STING Activators in Cancer Immunotherapy.International journal of nanomedicine · 2025Review
- Exploring the Therapeutic Potential of Vitamin D in Kawasaki Disease and Its Interplay with the COVID-19Turkish archives of pediatrics · 2024Article
- LncRNAs in Kawasaki disease and Henoch-Schönlein purpura: mechanisms and clinical applications.Molecular and cellular biochemistry · 2024Review
- The landscape of hot topics and research frontiers in Kawasaki disease: Scientometric analysis.Heliyon · 2024Article
- Platelet STING agonism and venous thrombosis: translational implications for improved disease outcomes.Journal of leukocyte biology · 2023Article
- Role of cGAS-STING signaling pathway in cardiometabolic diseases.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2023Article
- Severe COVID-19European respiratory review : an official journal of the European Respiratory Society · 2023Review
- Current understanding of the cGAS-STING signaling pathway: Structure, regulatory mechanisms, and related diseases.Zoological research · 2023Review
- Trafficking and effect of released DNA on cGAS-STING signaling pathway and cardiovascular disease.Frontiers in immunology · 2023Review
- COVID-19, Vaccination, Multisystem Inflammatory Syndrome, Aneurysm, Screening and Post Vaccination Death.International journal of preventive medicine · 2023Article
- Treatment of thrombosis in KD Patients using tissue plasminogen activator: a single center study.Pediatric rheumatology online journal · 2022Article
- Innate immune response analysis in COVID-19 and kawasaki disease reveals MIS-C predictors.Journal of the Formosan Medical Association = Taiwan yi zhi · 2022Article
- Hypersensitivity may be involved in severe COVID-19.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2022Article
- The cGAS-STING signaling in cardiovascular and metabolic diseases: Future novel target option for pharmacotherapy.Acta pharmaceutica Sinica. B · 2022Review
- Neutrophils in COVID-19: Not Innocent Bystanders.Frontiers in immunology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We previously made the hypothesis that STING contributes to COVID-19. The present review detail new arguments for over-activation of STING pathways in COVID-19, following the description of hyper-coagulability and Kawasaki-like diseases in children. Indeed, Kawasaki disease is induced by overreaction of innate cells following exposition to various viruses, including herpes viruses which trigger STING. It predisposes to diffuse vasculitis and aneurysms, whereas STING is over-expressed in arterial aneurisms. The redness at the inoculation site of bacillus Calmette-Guérin, a specific feature of Kawasaki disease, is reproduced by activation of the STING pathway, which is inhibited upstream by aspirin, intravenous immunoglobulins, and Vitamin-D. SARS-CoV2 binding to ACE2 can lead to excessive angiotensin II signaling, which activates the STING pathway in mice. Over-activation of the STING-pathway promotes hyper-coagulability through release of interferon-β and tissue factor by monocytes-macrophages. Aspirin and dipyridamole, besides their anti-platelet activity, also reduce tissue factor procoagulant activity, and aspirin inhibits the STING pathway upstream of STING. Aspirin and dipyridamole may be used, in combination with drugs blocking downstream the activation of the STING pathway, like inhibitors of IL-6R and JAK/STAT pathways. The risk of bleeding should be low as bleeding has not been reported in severe COVID-19 patients.
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