Fig. 2
From: Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance
Pro-thrombotic status induced by SARS-CoV-2 infection. SARS-CoV-2 can bind endothelial ACE2 receptor inducing downregulation. Decreased levels of ACE2 induce decreased levels of Ang1 and -7 and consequently vasoconstriction. Moreover, Ang2 tends to accumulate inducing vasoconstriction and increased levels of PAI-1 and thus, decreased fibrinolysis. Conversely, endothelial damage SARS-CoV-2 induced, mediate increased levels of TF inducing increased fibrin levels and increased levels of vWF and P-selectin mediating enhanced platelet adhesion. Abbreviations: ACE: angiotensin-converting enzyme; Ang: angiopoietin; PAI-1: plasminogen activator inhibitor-1; TF: tissue factor; vWF: Von Willebrand factor