Effects of coronavirus infection on markers of endothelial dysfunction in children with renal pathology

D. Yarovaya, O. Bashkina, Elena V. Krasilova
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Abstract

Coronavirus infection (COVID-19), caused by severe acute respiratory syndrome 2 (SARS-CoV-2) RNA virus, has become a global problem in the world. Its consequences are of great importance for the health status of both adults and children, since the number of lethal outcomes and life-threatening complications has reached high rates. Of particular importance is coronavirus damage of important organs in childhood, due to the possible impairment of their functions and the development of later distant complications. Thus, the formation of acute kidney injury (AKI) in children is an independent risk factor for hospital mortality and disability. An important role in the development of this pathological condition is given to the development of endothelial dysfunction due to the activation of a number of pro-inflammatory cytokines and other biomarkers of endothelial disorders. Endothelitis, endothelial injury, endothelial cell dysfunction, and impaired microcirculatory function in various vascular beds all contribute markedly to life-threatening complications of COVID-19 such as venous thromboembolism and multiple organ failure. Endothelial dysfunction is the main determinant of microvascular disorders due to a shift in vascular balance towards greater vasoconstriction and subsequent organ ischemia, inflammation with concomitant tissue edema and procoagulant condition. In general, understanding the mechanisms of endothelial activation and dysfunction during COVID-19 infection can contribute to early detection of individuals, especially children, at risk of severe complications. Further study of endothelial dysfunction in the pathogenesis of AKI in children with COVID-19 is promising to determine a personalized approach to the management of pediatric patients with COVID-19.
冠状病毒感染对肾病患儿内皮功能障碍标志物的影响
由严重急性呼吸综合征(SARS-CoV-2) RNA病毒引起的冠状病毒感染(COVID-19)已成为全球性问题。其后果对成人和儿童的健康状况都非常重要,因为致命后果和危及生命的并发症的发生率很高。特别重要的是,由于冠状病毒可能损害儿童重要器官的功能和后期远处并发症的发展,儿童重要器官受到损害。因此,儿童急性肾损伤(AKI)的形成是医院死亡和残疾的独立危险因素。由于许多促炎细胞因子和内皮疾病的其他生物标志物的激活,内皮功能障碍的发展在这种病理状况的发展中起着重要作用。各种血管床的内皮炎、内皮损伤、内皮细胞功能障碍和微循环功能受损都是COVID-19危及生命的并发症的重要因素,如静脉血栓栓塞和多器官功能衰竭。内皮功能障碍是微血管疾病的主要决定因素,因为血管平衡转向更大的血管收缩和随后的器官缺血、伴随组织水肿的炎症和促凝状态。总的来说,了解COVID-19感染期间内皮活化和功能障碍的机制有助于早期发现有严重并发症风险的个体,特别是儿童。进一步研究内皮功能障碍在COVID-19儿童AKI发病机制中的作用,有望确定针对COVID-19儿童患者的个性化治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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