ReviewThe Lancet. Respiratory medicine2021
A tricompartmental model of lung oxygenation disruption to explain pulmonary and systemic pathology in severe COVID-19.
Review in The Lancet. Respiratory medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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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.
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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
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Lower or higher oxygenation targets in the intensive care unit: an individual patient data meta-analysis.Intensive care medicine · 2024Pooled it
- COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells.Seminars in immunopathology · 2022Pooled it
- A Randomized Trial of Mesenchymal Stromal Cells for Moderate to Severe Acute Respiratory Distress Syndrome from COVID-19.American journal of respiratory and critical care medicine · 2023Trial
- SARS-CoV-2 spike-armed vesicular stomatitis virus recapitulates severe COVID-19 acute respiratory distress syndrome in mice.iScience · 2026Article
- Integrated Analysis of Parenchymal and Vascular HRCT Patterns with Circulating Biomarkers in Severe COVID-19 Pneumonia.Diagnostics (Basel, Switzerland) · 2026Article
- The virology of Omicron: pathophysiology, immune regulation, and clinical impact of SARS-CoV-2 sub variants.Virology journal · 2025Review
- Revisiting the monocrotaline-treated rat as a model of inflammatory lung disease: COVID-19 and future pandemic threats?Animal models and experimental medicine · 2025Review
- Article
- Viral uptake and pathophysiology of the lung endothelial cells in age-associated severe SARS-CoV-2 infection models.Aging cell · 2024Article
- Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020.Scientific reports · 2023Article
- COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy.Journal of clinical medicine · 2023Article
- Circulating Interleukin-8 Dynamics Parallels Disease Course and Is Linked to Clinical Outcomes in Severe COVID-19.Viruses · 2023Article
- Intrapulmonary Bronchopulmonary Anastomoses in Severe COVID-19-related Acute Respiratory Failure.American journal of respiratory and critical care medicine · 2022Article
- Chest dual-energy CT to assess the effects of steroids on lung function in severe COVID-19 patients.Critical care (London, England) · 2022Observational
- Virucidal PVP-Copper Salt Composites against Coronavirus Produced by Electrospinning and Electrospraying.Polymers · 2022Article
- Persistent isolated impairment of gas transfer following COVID-19 pneumonitis relates to perfusion defects on dual-energy computed tomography.ERJ open research · 2022Article
- Vasculopathy and Increased Vascular Congestion in Fatal COVID-19 and Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine · 2022Article
- Review
- Article
- The SARS-CoV-2 spike residues 616/644 and 1138/1169 delineate two antibody epitopes in COVID-19 mRNA COMINARTY vaccine (Pfizer/BioNTech).Scientific reports · 2022Article
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The emergent 21st century betacoronaviruses, including SARS-CoV-2, lead to clinicopathological manifestations with unusual features, such as early-onset chest pain, pulmonary infarction, and pulmonary and systemic thromboembolism that is pathologically linked to extensive capillary, arteriolar, and venular thrombosis. Early ground glass opacities detected by CT, which are reminiscent of lung infarcts associated with pulmonary embolism, point to a novel vascular pathology in COVID-19. Under physiological conditions, normal parenchymal oxygenation is maintained by three sources: the alveolus itself and dual oxygen supply from the pulmonary and bronchial artery circulations. We propose a model in which these three components are disrupted in COVID-19 pneumonia, with severe viral alveolitis and concomitant immunothrombotic obstruction of the pulmonary and bronchiolar circulation. Tricompartmental disruption might have two main consequences: systemic clot embolisation from pulmonary vein territory immunothrombosis, and alveolar-capillary barrier disruption with systemic access of thrombogenic viral material. Our model encompasses the known pathological and clinical features of severe COVID-19, and has implications for understanding patient responses to immunomodulatory therapies, which might exert an anti-inflammatory effect within the vascular compartments.
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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.