Gianni P, Goldin M, Ngu S, Zafeiropoulos S, Geropoulos G, Giannis D. Complement-mediated microvascular injury and thrombosis in the pathogenesis of severe COVID-19: A review. World J Exp Med 2022; 12(4): 53-67 [PMID: 36157337 DOI: 10.5493/wjem.v12.i4.53]
Corresponding Author of This Article
Dimitrios Giannis, MD, MSc, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra Blvd, Hempstead, NY 11549, United States. dimitrisgiannhs@gmail.com
Research Domain of This Article
Immunology
Article-Type of This Article
Review
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Gianni P, Goldin M, Ngu S, Zafeiropoulos S, Geropoulos G, Giannis D. Complement-mediated microvascular injury and thrombosis in the pathogenesis of severe COVID-19: A review. World J Exp Med 2022; 12(4): 53-67 [PMID: 36157337 DOI: 10.5493/wjem.v12.i4.53]
World J Exp Med. Jul 20, 2022; 12(4): 53-67 Published online Jul 20, 2022. doi: 10.5493/wjem.v12.i4.53
Complement-mediated microvascular injury and thrombosis in the pathogenesis of severe COVID-19: A review
Panagiota Gianni, Mark Goldin, Sam Ngu, Stefanos Zafeiropoulos, Georgios Geropoulos, Dimitrios Giannis
Panagiota Gianni, Department of Internal Medicine III, Hematology, Oncology, Palliative Medicine, Rheumatology and Infectious Diseases, University Hospital Ulm, Ulm 89070, Germany
Mark Goldin, Sam Ngu, Dimitrios Giannis, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New York, NY 11549, United States
Mark Goldin, Feinstein Institutes for Medical Research at Northwell Health, Feinstein Institutes , New York, NY 11030, United States
Stefanos Zafeiropoulos, Elmezzi Graduate School of Molecular Medicine, Northwell Health, New York, NY 11030, United States
Georgios Geropoulos, Department of General Surgery, University College London Hospitals, London NW12BU, United Kingdom
Dimitrios Giannis, North Shore/Long Island Jewish General Surgery, Northwell Health, New York, NY 11021, United States
Author contributions: Gianni P, and Giannis D led the study including review of the literature, data analysis, and drafted the manuscript; Goldin M, Ngu S, Geropoulos G and Zafeiropoulos S contributed to the editing, data analysis and critical review of the manuscript; all authors are agreeable to be accountable for all aspects of the work and gave final approval of the version to be published.
Conflict-of-interest statement: All the authors declare no conflict of interests for this article.
Corresponding author: Dimitrios Giannis, MD, MSc, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 500 Hofstra Blvd, Hempstead, NY 11549, United States. dimitrisgiannhs@gmail.com
Received: February 9, 2022 Peer-review started: February 9, 2022 First decision: April 13, 2022 Revised: April 27, 2022 Accepted: June 13, 2022 Article in press: June 13, 2022 Published online: July 20, 2022 Processing time: 160 Days and 1 Hours
Core Tip
Core Tip: Current evidence supports the role of excessive complement activation with subsequent illness progression and development of a complement-dependent cytotoxic tissue damage with detrimental effects in coronavirus disease 2019 (COVID-19) patients, including thromboembolic complications. Based on its role in the development of the cytokine storm and thrombogenesis in COVID-19, the complement system is an appealing treatment target with promising results from preliminary reports. Whether inhibition of upstream (C3, C1) or terminal (C5, C5a, or C5aR) components is of equal importance remains to be elucidated, however, preliminary results from several ongoing clinical trials show benefit in terms of 28-d mortality and pulmonary embolism.
