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MeSH Disease

Human Phenotype

Transmission

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Seroprevalence
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    COVID-19: Neutrophils “Unfriendly Fire” Imbalance Proteolytic Cascades Triggering Clinical Worsening and Viral Sepsis MESHD Sepsis HP. Potential Role Explanation for Convalescent Plasma SERO as “Fire Hose”

    Authors: Pier Maria Fornasari

    id:10.20944/preprints202005.0373.v1 Date: 2020-05-23 Source: Preprints.org

    Based on Chinese CDCP report on COVID-19, 14% of patients presented severe disease and 5% critical conditions. The average case-fatality rate was 2.3%, but mortality was as high as 49% in patients with critical illness MESHD. Serious life threatening thromboembolic MESHD complications have been found in 71·4% of non-survivors and micro/macro angiopathic coagulopathy MESHD has been found, also at autopsy, with highly increased neutrophil number, fibrinogen, concentrations of D-dimer and FDPs and NETs, ATIII decrease and normal number of platelets. A cytokine storm and interaction between inflammation MESHD and coagulation has been advocated as explanation of hypercoagulability HP hypercoagulability MESHD. In this paper, it’s hypothesised that SARS-CoV-2 infection MESHD of alveolar MESHD cells induces recruitment of innate responder neutrophils, which release proteases and NETs inducing endothelial damage/endotheliopathy and imbalance of the four major proteolytic cascades (coagulation, complement, fibrinolysis and kallikrein) with prevalence SERO of activators over inhibitors and consequent thrombotic complications MESHD. Platelets adhesion to damaged endothelium and the presence of ULVWF multimers, due to decreased ADAMTS13, contributes to the state of hypercoagulability HP hypercoagulability MESHD. Neutrophil innate “unfriendly fire” response can be identified as the trigger of a “proteolytic storm”, responsible for subsequent well known prothrombotic condition and “cytokine storm”. The hypothesis explains also the pathology of recently described systemic “ Kawasaki Disease MESHD like” vasculitis HP vasculitis MESHD cases in Covid-19 young ill patients.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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