The misunderstood link between SARS-CoV-2 and angiogenesis. A narrative review

Autores da FMUP

• Raquel Ângela Silva Soares Lino

  Autor

Participantes de fora da FMUP

• Madureira, G

Unidades de investigação

• Biomedicina

Abstract

Novel Coronavirus Disease 2019 (Covid-19) is associated with multi-systemic derangement, including circulatory dysfunction with features of endothelial dysfunction, micro-angiopathic thrombosis and angiocentric inflammation. Recently, intussusceptive angiogenesis has been implicated in the pathogenesis of the disease.Herein, we conducted a narrative review according to the SANRA guidelines to review and discuss data regarding splitting angiogenesis including mechanisms, drivers, regulators and putative roles. Relevant angiogenic features in Covid-19, including their potential role in inflammation, endothelial dysfunction and permeability, as well as their use as prognos-tic markers and therapeutic roles are reviewed. Splitting angiogenesis in Covid-19 involve hypoxia, hypoxia-inducible factors, classic angiogenic mediators, such as the Vascular Endo-thelial Growth Factor (VEGF), Angiopoietins, hyperinflammation and cytokine storm, and dysregulation of the Renin-Angiotensin-Aldosterone System, which combined, interact to promote intussusception.Data regarding the use of angiogenic mediators as prognostic tools is summarized and suggest that angiopoietins and VEGF are elevated in Covid-19 patients and predictors of adverse out-comes. Finally, we reviewed the scarce data regarding angiogenic mediators as therapeutic tar-gets. These preliminary findings suggest a potential benefit of bevacizumab as an add-on therapy.& COPY; 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

• Cytokine storm; Endothelialitis; Microenvironment factors; SARS-CoV-2 infection