Infección por SARS-CoV-2. Una nueva enfermedad endotelial trombo-inflamatoria

Abstract

Coronavirus disease 19 is characterized by an intense inflammatory response and a high incidence of thrombotic events. Autopsy studies show severe endothelial injury associated with thrombosis of the alveolar capillaries of the lungs and other organs. In the pathophysiology of this disease endothelial injury and dysfunction, inflammation and thrombosis are key factors for the development of severe phenotypes. Therefore, we should consider this entity as a systemic endothelial disease in which an obstructive microvascular syndrome secondary to an intense thrombo-inflammatory response leads to acute respiratory insufficiency and multiorgan failure. Heparin is an excellent drug to treat Covid-19 patients due to its anticoagulant, anti-inflammatory, antiviral and endothelial effects. Clinical guidelines agree that the use of heparin thromboprophylaxis is a component of Covid-19 coagulopathy treatment, even though the dose and duration of treatments are not well defined.