Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

• Published in: Cytokine & growth factor reviews Vol. 63; pp. 58 - 68
• Main Authors: Ahmad, Firdos, Kannan, Meganathan, Ansari, Abdul W.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2022
• Subjects: Advanced Basic Science; Blood Coagulation Disorders - complications; Coagulopathy; COVID-19; COVID-19 - complications; Cytokines; Growth factors; Humans; Inflammation; Mini Review; Platelet activation; SARS-CoV-2; Thromboembolism; Venous Thromboembolism - etiology; COVID-19; Platelet activation; Cytokines; Inflammation; Thromboembolism; Growth factors; Coagulopathy
• ISSN: 1359-6101; 1879-0305
• DOI: 10.1016/j.cytogfr.2021.10.007

Severe COVID-19 patients frequently present thrombotic complications which commonly lead to multiorgan failure and increase the risk of death. Severe SARS-CoV-2 infection induces the cytokine storm and is often associated with coagulation dysfunction. D-dimer, a hallmark of venous thromboembolism (VTE), is observed at a higher level in the majority of hospitalized COVID-19 patients. The precise molecular mechanism of the disproportionate effect of SARS-CoV-2 infection on the coagulation system is largely undefined. SARS-CoV-2 –induced endotheliopathy and, induction of cytokines and growth factors (GFs) most likely play important roles in platelet activation, coagulopathy, and VTE. Generally, viral infections lead to systemic inflammation and induction of numerous cytokines and GFs and many of them are reported to be associated with increased VTE. Most importantly, platelets play key thromboinflammatory roles linking coagulation to immune mediators in a variety of infections including response to viral infection. Since the pathomechanism of coagulopathy and VTE in COVID-19 is largely undefined, herein we highlight the association of dysregulated inflammatory cytokines and GFs with thrombotic complications and coagulopathy in COVID-19. [Display omitted] •There is association between a cytokine storm and coagulation dysfunction in reported viral pandemics including COVID-19.•An increased TF expression on different cells and decreased TFPI likely contribute to the coagulation dysfunction.•Platelet activation markers P-selecin and sCD40L along with growth factors play important roles in COVID-19 pathogenesis.•The pattern of coagulation pathway in COVID-19 appears to be different than the traditional coagulation pathway.