Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thromboembolic events in the
acute setting. However, the abnormal thrombotic diathesis is not known to persist into the recovery phase of
COVID-19 infection.
We described 3 cases of ST-segment elevation myocardial infarction in healthy male patients who
recovered from COVID-19 with no prior cardiovascular risk factors. They shared features of elevated
von Willebrand factor antigen, factor VIII and D-dimer level. One patient had a borderline positive lupus
anticoagulant. Intravascular ultrasound of culprit vessels revealed predominantly fibrotic plaque with
minimal necrotic core. Clot waveform analysis showed parameters of hypercoagulability. They were
treated with dual antiplatelet therapy, angiotensin-converting-enzyme inhibitor, beta blocker and statin.
These cases highlight the strong thrombogenic nature of COVID-19 that persisted among patients who
recovered from infection. Several suspected mechanisms could explain the association between vascular
thrombosis in the convalescent period (endothelial dysfunction, hypercoagulability, systemic inflammatory
response and vasculopathy). Additional studies on “long COVID” are essential for identifying endotheliopathy
and thrombotic sequalae.
Keywords: Coronary artery disease, hypercoagulability, pandemic, thrombosis
1. As a potential new drug candidate for cardiovascular protection and antitumor treatment, the physicochemical properties, gastrointestinal (GI) absorption behaviors and mechanisms of S-propargyl-cysteine (SPRC) were investigated in this study. 2. SPRC exhibited favorable solubility in aqueous media. The log P and log D values were low (≤1.93 ± 0.08). The pKa in the acidic and basic regions was 2.08 ± 0.02 and 8.72 ± 0.03, respectively. The isoelectric point was 5.40 ± 0.02. SPRC was stable in the rat GI fluids, and showed no obvious adsorption and metabolism in the rat GI tract. 3. SPRC displayed poor gastric absorption and favorable intestinal absorption in the rat in situ GI perfusion model. Absorption rate constants (ka), hourly absorption percentage (P) and apparent permeability coefficient (Papp) of SPRC in the small intestine were ≥0.77 ± 0.06 h(-1), 59.25 ± 4.02% and (7.99 ± 0.88) × 10(-5 )cm/s, respectively. Absorption of SPRC exhibited a certain dependence on physiological pH and absorption region. Absorption of SPRC was not inhibited by l-methionine and 2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid. 4. SPRC showed favorable oral absorption. It can be categorized as a BCS class I drug. The membrane pore transport appeared to be one of the predominant absorption modes for SPRC.
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