Understanding the Pathology
· Microbiologists from University of Kansas Medical Center monitored long-term SARS-CoV-2 replication in polarized human airway epithelium cells and found that SARS-CoV-2 exhibits a cyclically peaked replication profile and primarily infects ciliated and goblet cells with minimal basal or club cell replication. This led the researchers to propose that recurrent or long-term COVID-19 is enabled through a cycle of epithelial cell damage and virus release, cell regeneration, and infection of the newly repaired epithelium.
Management
· Hematologists at the Italian National Blood Centre in Rome, Italy review literature regarding management of SARS-CoV-2 induced coagulopathy and outline proposed pathophysiology, laboratory studies (inflammatory markers [IL-6, CRP, procalcitonin, ferritin], coagulopathy markers [D-Dimer, platelet count, fibrinogen]), and potential usefulness of prophylactic treatment with low molecular weight heparin (LMWH). They recommend anticoagulant prophylaxis should be personalized according to each patient's disease course and thrombotic risk profile.
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