Is COVID-19 a New Hematologic Disease?

Abstract

SARS-CoV-2 viruses are positive single-stranded RNA viruses, whose infection can be asymptomatic or lead to the coronavirus disease 2019 . Covid-19 is a respiratory infection with a significant impact on the hematopoietic system and hemostasis leading to several cardiovascular complications. Hematologic consequences of this new infection allowed medical community to start new treatment approaches concerning infection going from targeted anti-inflammatory drugs to anticoagulation or stem cell therapies. A better understanding of Covid-19 pathophysiology, in particular hematological disorders, will help to choose appropriate treatment strategies.

No evidence for basigin/CD147 as a direct SARS-CoV-2 spike binding receptor

“…Despite the importance of determining precisely which entry receptors SARS-CoV-2 uses to infect human cells, there remains considerable uncertainty amid multiple claimed viral receptors with variable qualities of data behind them 9,[32][33][34][35] . We investigated one of the most prominent claims among these, that human BSG acts as an alternate receptor for the virus to interact with, which has been the topic of several studies, news and review articles, and a clinical trial 8,14,15,[36][37][38][39] . Our access to established tools and reagents from previous work studying BSG's role as a host receptor in Plasmodium infection allowed us to rapidly investigate BSG as a SARS-CoV-2 receptor.…”

“…Notably, SARS-CoV-2 has not been found to enter red blood cells 42 . However, the possibility that BSG could act as an accessory binding receptor for the virus has been speculated in several publications to possibly explain in part the link between SARS-CoV-2 infection and hematological symptoms in patients 38,39,43,44 . Our data suggest this hypothesis should be treated cautiously.…”

“…To generate transfected cells overexpressing cell-surface receptors, human embryonic kidney (HEK)-293E cells were seeded one day prior to transfection at a density of 2.5x10 5 cells per mL in Freestyle Media (Life Technologies #12338018) supplemented with 10% heat-inactivated fetal bovine serum (FBS). Cells were transiently transfected with polyethylenimine as previously described 39,4 , except with double the ratio of DNA to cells. Then 48 hours after transfection, cells had culture media aspirated and were resuspended in 1 μM DAPI (Biolegend #422801) and incubated on ice for 5 minutes.…”

D-dimers at hospital admission for COVID-19 are associated with in hospital mortality independently of venous thromboembolism: Insight from a French multicenter cohort study

“…Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with various clinical respiratory syndromes, ranging from mild upper airway symptoms to progressive life-threatening viral pneumopathy (1,2). Patients with severe coronavirus disease 2019 (COVID-19) have progressive hypoxemia inducing need of mechanical ventilatory support.…”

“…However, more than these macrothrombotic events, microvascular thrombosis in the lungs has been reported following autopsies, suggesting acute respiratory distress syndrome in COVID-19 (10)(11)(12). Thrombo-in ammatory process in pulmonary capillary vessels is probably the main actor of microthrombosis in lung capillaries that induces COVID-19associated coagulopathy (13), characterized by an increase in procoagulant factors such as brinogen, together with a strong increase of D-dimers at admission (1,2,14). Level of D-dimers at admission has been associated to in-hospital mortality in several studies (1,14,15), however the cut-off allowing deciphering patients with favorable and poor outcomes is still a matter of debate.…”