Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis
Fabio Ciceri(Vita-Salute San Raffaele University), Luigi Beretta(Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele), Anna Mara Scandroglio(Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele), Sergio L. Colombo(Vita-Salute San Raffaele University), Giovanni Landoni(Vita-Salute San Raffaele University), Annalisa Ruggeri(Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele), Jacopo Peccatori(Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele), Armando D’Angelo(Vita-Salute San Raffaele University), Francesco De Cobelli(Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele), Patrizia Rovere‐Querini(Vita-Salute San Raffaele University), Moreno Tresoldi(Vita-Salute San Raffaele University), Lorenzo Dagna(Istituti di Ricovero e Cura a Carattere Scientifico), Alberto Zangrillo(Istituti di Ricovero e Cura a Carattere Scientifico)
Cited by 491Open Access
Abstract
We suggest the use of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) as a new name for severe pulmonary coronavirus disease 2019 (COVID-19). We hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. Future steps in the understanding of the disease and in the identification of treatments may benefit from this definition and hypothesised sequence of events.
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