The mechanistic basis linking cytokine storm to thrombosis in COVID-19

• Published in: Thrombosis update Vol. 8; p. 100110
• Main Authors: Wolf, Adam, Khimani, Faria, Yoon, Braian, Gerhart, Coltin, Endsley, Dakota, Ray, Anish K., Yango, Angelito F., Flynn, Stuart D., Lip, Gregory Y.H., Gonzalez, Stevan A., Sathyamoorthy, Mohanakrishnan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2022; The Authors. Published by Elsevier Ltd; Elsevier
• Subjects: Clots; Coagulopathy; COVID-19; Cytokine storm; SARS-CoV2; Thrombosis; COVID-19; SARS-CoV2; Cytokine storm; Thrombosis; Coagulopathy; Clots
• ISSN: 2666-5727; 2666-5727
• DOI: 10.1016/j.tru.2022.100110

It is now well established that infection with SARS-CoV-2 resulting in COVID-19 disease includes a severely symptomatic subset of patients in whom an aggressive and/or dysregulated host immune response leads to cytokine storm syndrome (CSS) that may be further complicated by thrombotic events, contributing to the severe morbidity and mortality observed in COVID-19. This review provides a brief overview of cytokine storm in COVID-19, and then presents a mechanistic discussion of how cytokine storm affects integrated pathways in thrombosis involving the endothelium, platelets, the coagulation cascade, eicosanoids, auto-antibody mediated thrombosis, and the fibrinolytic system. •Cytokine Storm Syndrome in COVID-19 is associated with major thrombotic events.•Thrombosis in this syndrome is related to simultaneous stimulation of prothrombotic factors and inhibitory effects on fibrinolysis.•These occur through effects on platelets, neutrophil NETS, the endothelium, the coagulation cascade, eicosanoids, autoantibodies, and fibrinolysis.