ArticleCirculation2020
Immunothrombotic Dysregulation in COVID-19 Pneumonia Is Associated With Respiratory Failure and Coagulopathy.
Article in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 349 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
349 citing papers in PubMed, 2 syntheses or guidelines pooled it, 566 citations in OpenAlex.
- Association of post-thrombotic syndrome with metabolic syndrome and inflammation - a systematic review.Frontiers in immunology · 2025Pooled it
- An ancient examination in the face of a modern pandemic: systematic review of major clinicopathological autopsy findings.Revista da Associacao Medica Brasileira (1992) · 2022Pooled it
- Targeting GPVI with glenzocimab in COVID-19 patients: Results from a randomized clinical trial.PloS one · 2024Trial
- Early administration of tocilizumab in hospitalized COVID-19 patients with elevated inflammatory markers; COVIDSTORM-a prospective, randomized, single-centre, open-label study.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022Trial
- Trial
- Increased prevalence of deep vein thrombosis and mortality in patients with Covid-19 at a referral center in Brazil.Phlebology · 2022Trial
- A functionally distinct neutrophil landscape in severe COVID-19 reveals opportunities for adjunctive therapies.JCI insight · 2022Trial
- Arterial and venous thromboembolism in hospitalized patients with COVID-19: a national multicenter cohort study.Blood vessels, thrombosis & hemostasis · 2026Article
- Procoagulant platelets: linking coagulation and thromboinflammation in cardiovascular disease.Nature reviews. Cardiology · 2026Review
- Impact of COVID-19 Infection and Vaccination on Abdominal-based Microvascular Breast Reconstruction Outcomes.Plastic and reconstructive surgery. Global open · 2026Article
- Blood Coagulation in COVID-19: Systems-Biology Evidence, Clinical Implications, and Therapeutic Opportunities in an Evolving Pandemic.ACS omega · 2026Article
- CD177⁺ neutrophil-platelet aggregates contribute to thromboinflammation via NETs in necrotizing enterocolitis.Nature communications · 2026Article
- Automatic classification of circulating blood cell clusters based on multi-channel flow cytometry imaging.Engineering applications of artificial intelligence · 2026Article
- Renal microthrombosis and thrombomodulin deficiency in COVID-19-associated acute kidney injury.BMC nephrology · 2026Observational
- Platelet-derived integrin- and tetraspanin-enriched tethers exacerbate severe inflammation.Science (New York, N.Y.) · 2026Article
- Neutrophil Extracellular Traps in Heart Failure: From Pathophysiological Mechanisms to Therapeutic Targets.Journal of inflammation research · 2026Review
- Neutrophil Dynamics in Viral Infections: Drivers of Inflammation and Targets for Pro-Resolving Therapies.Journal of innate immunity · 2026Review
- Disturbed regulation of immunothrombosis in cerebral ischemia associated with SARS-CoV-2 infection.Frontiers in immunology · 2026Article
- Cardiovascular sequelae of Long COVID: immune dysregulation inflammation as central drivers.Frontiers in immunology · 2026Review
- Pulmonary sequelae of SARS-CoV-2 infection: a narrative review of long-term functional, radiological, and clinical outcomes in COVID-19 survivors, with a regional focus on Saudi Arabia.Frontiers in physiology · 2026Review
289 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
22 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere acute respiratory syndrome corona virus 2 infection causes severe pneumonia (coronavirus disease 2019 [COVID-19]), but the mechanisms of subsequent respiratory failure and complicating renal and myocardial involvement are poorly understood. In addition, a systemic prothrombotic phenotype has been reported in patients with COVID-19.
methodsA total of 62 subjects were included in our study (n=38 patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19 and n=24 non-COVID-19 controls). We performed histopathologic assessment of autopsy cases, surface marker-based phenotyping of neutrophils and platelets, and functional assays for platelet, neutrophil functions, and coagulation tests, as well.
resultsWe provide evidence that organ involvement and prothrombotic features in COVID-19 are linked by immunothrombosis. We show that, in COVID-19, inflammatory microvascular thrombi are present in the lung, kidney, and heart, containing neutrophil extracellular traps associated with platelets and fibrin. Patients with COVID-19 also present with neutrophil-platelet aggregates and a distinct neutrophil and platelet activation pattern in blood, which changes with disease severity. Whereas cases of intermediate severity show an exhausted platelet and hyporeactive neutrophil phenotype, patients severely affected with COVID-19 are characterized by excessive platelet and neutrophil activation in comparison with healthy controls and non-COVID-19 pneumonia. Dysregulated immunothrombosis in severe acute respiratory syndrome corona virus 2 pneumonia is linked to both acute respiratory distress syndrome and systemic hypercoagulability.
conclusionsTaken together, our data point to immunothrombotic dysregulation as a key marker of disease severity in COVID-19. Further work is necessary to determine the role of immunothrombosis in COVID-19.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.