Microcirculatory changes and thrombotic complications in COVID-19
Despite its many devastating effects, the COVID-19 pandemic has had a positive impact in the ways in which society, scientific institutions, governing bodies, businesses, educational organisations, and communication have functioned unchallenged over the years. Rapid advancement in science enabled identification and characterisation of the virus and in developing vaccines to combat the disease. The mysterious ways in which the virus attacks the vital organs that lead on to multiorgan failure and thrombosis of the arterial and venous system have also been revealed. The ability to study the microcirculatory changes at the bedside and predict prognosis is a way forward. All the evidence suggests that the outcome of COVID-19 infection is related to the severity of the disease seen in the intensive care unit setting. This article discusses microcirculatory changes and immune coagulopathy caused by COVID-19.
Over the centuries, pandemics have annihilated human civilisation. During the last two millennia, the world has seen three pandemics of plagues, seven of cholera, several influenza pandemics and at least three epidemics and pandemics due to coronaviruses, with associated losses of millions of lives (Walsh, 2020). There has never been such interest, media coverage, availability of wealth of scientific data, advancement of knowledge and urgency in containing the pandemic as seen with COVID-19. At the time of writing, over 180 million people have contracted COVID-19 infection, and more than 4 million people have died of COVID-19 infection worldwide. Several million people are now experiencing ‘long COVID’-a persistence of symptoms from the acute phase of illness. Further, there are a large number of patients recovering from the complications of COVID infection following prolonged stay in the intensive care unit (ICU). Although the virus has not yet been contained, scientific advancements have certainly enabled a reduction in mortality.
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