ArticleJournal of thrombosis and haemostasis : JTH2021
Pathology of lung-specific thrombosis and inflammation in COVID-19.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- SARS-Cov-2 infection and neuropathological findings: a report of 18 cases and review of the literature.Acta neuropathologica communications · 2023Pooled it
- Microscopic vessel caliber patterns in pulmonary thromboembolism: Clinical and autopsy correlations in a 10-year autopsy series.Forensic science, medicine, and pathology · 2026Article
- Brain-derived microvesicles induce activation of aspirin-treated platelets via the PLC/PKC pathway.Scientific reports · 2026Article
- Tryptophan metabolism reprogramming potentially contributes to the prothrombotic milieu in mice and humans with SARS-CoV-2.Blood vessels, thrombosis & hemostasis · 2026Article
- SARS-CoV-2 uptake and inflammatory response in senescent endothelial cells are regulated by the BSG/VEGFR2 pathway.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- The COVID-19 thrombus: distinguishing pathological, mechanistic, and phenotypic features and management.Journal of thrombosis and thrombolysis · 2025Review
- Severe COVID-19 induces prolonged elevation of the acute-phase protein pentraxin 3.Frontiers in immunology · 2025Article
- Risk impact of SARS-CoV-2 coronavirus and spike protein on cardiac tissue: a comprehensive review.Physiological research · 2024Review
- Arterial Thrombosis in Acute Respiratory Infections: An Underestimated but Clinically Relevant Problem.Journal of clinical medicine · 2024Review
- COVID-19 Coagulopathy.Life (Basel, Switzerland) · 2024Review
- Using the ClinFIT COVID-19 Instrument to Assess the Functional Impairments Specific to Post-COVID-19 Patients in Romania.Diagnostics (Basel, Switzerland) · 2024Article
- S100A9: The Unusual Suspect Connecting Viral Infection and Inflammation.Journal of immunology (Baltimore, Md. : 1950) · 2024Review
- Advances in Nano-Functional Materials in Targeted Thrombolytic Drug Delivery.Molecules (Basel, Switzerland) · 2024Review
- Article
- Mechanism and role of mitophagy in the development of severe infection.Cell death discovery · 2024Review
- Role and intervention of PAD4 in NETs in acute respiratory distress syndrome.Respiratory research · 2024Review
- Pathophysiological, immunological, and inflammatory features of long COVID.Frontiers in immunology · 2024Review
- Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ.Viruses · 2023Article
- The central role of neutrophil extracellular traps (NETs) and by-products in COVID-19 related pulmonary thrombosis.Immunity, inflammation and disease · 2023Review
- Pulmonary Thrombosis despite Therapeutic Anticoagulation in COVID-19 Pneumonia: A Case Report and Literature Review.Viruses · 2023Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundInfection by SARS-CoV-2 produces significant pulmonary pathology including endothelial damage with resultant thrombotic events. While pathologic features were described, there are limited data on the relationship of these changes to the inflammatory response and the production of thromboses.
objectiveTo investigate pathology of COVID-19-related immunothrombosis. PATIENTS/
methodsTissue samples from lung, kidney, brain and heart that were collected from 45 patients who died of COVID-19. Histopathological examination was performed after H&E and Picro-Mallory staining in combination with (immuno)fluorescence to visualize neutrophil extracellular traps. Ultrastructural alterations in lungs were studied with scanning and transmission electron microscopy.
resultsInflammatory changes and thrombosis were substantially more pronounced in the lung than in the kidney, heart, and brain. The most common pathologic finding was diffuse alveolar damage. In addition, most lung samples showed thrombi in vessels. The cause of death in single cases was massive pulmonary embolism. Ultrastructural examination revealed neutrophils attached to endothelium, perhaps as a step towards transendothelial migration. In addition, platelets were identified in the midst of fibrin as individual procoagulant balloon-like cells. Ultrastructural examination demonstrated numerous virion-like particles.
conclusionsStudying (ultra)structural features of the autopsy lung samples from patients with COVID-19 has provided evidence for a pathogenic link between inflammation and thrombosis. The major features in the lungs of COVID-19 patients comprised primary inflammatory thrombosis associated with diffuse alveolar damage. The lungs had pronounced circulatory changes with inflammation-dependent intravascular blood clotting, whereas heart, brain, and kidneys had predominantly degenerative changes that were distinct from the lung pathology.
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