ReviewJournal of neuroimaging : official journal of the American Society of Neuroimaging2020
COVID-19 as a Blood Clotting Disorder Masquerading as a Respiratory Illness: A Cerebrovascular Perspective and Therapeutic Implications for Stroke Thrombectomy.
Review in Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- COVID-19 associated brain/spinal cord lesions and leptomeningeal enhancement: A meta-analysis of the relationship to CSF SARS-CoV-2.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2021Pooled it
- Physical activity during COVID-19 pandemic: A 5-year retrospect.Sports medicine and health science · 2025Review
- Management of COVID-19 associated coagulopathy in critically ill patients and the risk of acquired von willebrand syndrome.Scientific reports · 2025Article
- Bridging the gap between CVD and COVID-19: the oxidized LDL hypothesis.Frontiers in medicine · 2025Article
- The alarming link between the COVID-19 pandemic and stroke: why ignoring this association after relapse of the disease has dangerous consequences.Journal of basic and clinical physiology and pharmacology · 2024Article
- Stem cell transplantation in cerebrovascular accidents: A global bibliometric analysis (2000-2023).World journal of stem cells · 2024Article
- The interplay of aging, adipose tissue, and COVID-19: a potent alliance with implications for health.GeroScience · 2024Review
- Article
- Factors associated with bleeding complications in patients with coronavirus disease 2019 admitted to intensive care units: A multicenter retrospective cohort study.Journal of diabetes investigation · 2023Observational
- Comparison of platelet-and endothelial-associated biomarkers of disease activity in people hospitalized with Covid-19 with and without HIV co-infection.Frontiers in immunology · 2023Article
- Review
- Direct, indirect, post-infection damages induced by coronavirus in the human body: an overview.Virusdisease · 2022Review
- An explanatory machine learning framework for studying pandemics: The case of COVID-19 emergency department readmissions.Decision support systems · 2022Article
- The influence of SARS-CoV-2 vaccination on post-operative outcomes in microsurgery patients.Microsurgery · 2022Article
- Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study.Journal of clinical medicine · 2022Article
- Aging whole blood transcriptome reveals candidate genes for SARS-CoV-2-related vascular and immune alterations.Journal of molecular medicine (Berlin, Germany) · 2022Article
- Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature.Life (Basel, Switzerland) · 2022Review
- Review
- Mathematical Approach to Investigate Stress due to Control Measures to Curb COVID-19.Computational and mathematical methods in medicine · 2022Article
- Endothelial dysfunction and COVID-19 (Review).Biomedical reports · 2021Review
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 2 institutions in 3 countries.
Funding
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the name suggests was initially thought to only cause a respiratory illness. However, several reports have been published of patients with ischemic strokes in the setting of coronavirus disease 2019 (COVID-19). The mechanisms of how SARS-CoV-2 results in blood clots and large vessel strokes need to be defined as it has therapeutic implications. SARS-CoV-2 enters the blood stream by breaching the blood-air barrier via the lung capillary adjacent to the alveolus, and then attaches to the angiotensin-converting enzyme II receptors on the endothelial cells. Once SARS-CoV-2 enters the blood stream, a cascade of events (Steps 1-8) unfolds including accumulation of angiotensin II, reactive oxygen species, endothelial dysfunction, oxidation of beta 2 glycoprotein 1, formation of antiphospholipid antibody complexes promoting platelet aggregation, coagulation cascade, and formation of cross-linked fibrin blood clots, leading to pulmonary emboli (PE) and large vessel strokes seen on angiographic imaging studies. There is emerging evidence for COVID-19 being a blood clotting disorder and SARS-CoV-2 using the respiratory route to enter the blood stream. As the blood-air barrier is breached, varying degrees of collateral damage occur. Although antiviral and immune therapies are studied, the role of blood thinners in the prevention, and management of blood clots in Covid-19 need evaluation. In addition to ventilators and blood thinners, continuous aspiration and clot retrieval devices (approved in Europe, cleared in the United States) or cyclical aspiration devices (approved in Europe) need to be considered for the emergent management of life-threatening clots including PE and large vessel strokes.
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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.