Should COVID-19 be branded to viral thrombotic fever?

Memorias do Instituto Oswaldo Cruz

article

Rubens Carmo Costa-Filho¹  Hugo Caire Castro-Faria Neto²  José Mengel³  Marcelo Pelajo-Machado⁴  Marco Aurélio Martins⁵  Érica Távora Leite⁶  Hugo Tannus Mendonça-Filho⁷  Tatiana de Arruda Campos Brasil de Souza⁸  Gonzalo Bentacor Bello⁹  José Paulo Gagliardi Leite^1,10 

[1] Hospital Pró-Cardíaco, United-Health Group;Instituto Oswaldo Cruz, Laboratório de Imunofarmacologia;Instituto Oswaldo Cruz, Laboratório de Imunologia Clínica;Instituto Oswaldo Cruz, Laboratório de Patologia;Instituto Oswaldo Cruz, Laboratório de Inflamação;Instituto Nacional de Câncer;Políticas de Saúde do United-Health Group;Instituto Carlos Chagas, Laboratório de Proteômica Estrutural e Computacional;Instituto Oswaldo Cruz, Laboratório de AIDS e Imunologia Molecular;Instituto Oswaldo Cruz, Laboratório de Virologia Comparada e Ambiental

关键词: endothelium;    COVID-19;    SARS-CoV-2;    SARS CoV Mpro;    inflammation;    coagulation;    hypercoagulability;    thrombosis;    thromboelastometry;   

DOI  :  10.1590/0074-02760200552

学科分类：地质学

来源: Bioline International

【 摘 要 】

Coronaviruses can cause a diverse array of clinical manifestations, from fever with symptoms of the common cold to highly lethal severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS). SARS-CoV-2, the coronavirus discovered in Hubei province, China, at the end of 2019, became known worldwide for causing coronavirus disease 2019 (COVID-19). Over one year’s time period, the scientific community has produced a large bulk of knowledge about this disease and countless reports about its immune-pathological aspects. This knowledge, including data obtained in postmortem studies, points unequivocally to a hypercoagulability state. However, the name COVID-19 tells us very little about the true meaning of the disease. Our proposal is more comprehensive; it intends to frame COVID-19 in more clinical terminology, making an analogy to viral haemorrhagic fever (VHF). Thus, we found irrefutable evidence in the current literature that COVID-19 is the first viral disease that can be branded as a viral thrombotic fever. This manuscript points out that SARS-CoV-2 goes far beyond pneumonia or SARS. COVID-19 infections promote remarkable interactions among the endothelium, coagulation, and immune response, building up a background capable of promoting a “thrombotic storm,” much more than a “cytokine storm.” The importance of a viral protease called main protease (Mpro) is highlighted as a critical component for its replication in the host cell. A deeper analysis of this protease and its importance on the coagulation system is also discussed for the first time, mainly because of its similarity with the thrombin and factor Xa molecules, as recently pointed out by structural comparison crystallographic structures.

【 授权许可】

Free