COVID-19 Pathophysiology

SARS-CoV-2 binds ACE2 receptors distributed broadly across the vascular endothelium of many organs, enabling multi-organ spread. COVID-19 is best understood as a multi-organ vascular disease rather than primarily a respiratory illness. Per…

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SARS-CoV-2 binds ACE2 receptors distributed broadly across the vascular endothelium of many organs, enabling multi-organ spread. COVID-19 is best understood as a multi-organ vascular disease rather than primarily a respiratory illness. Persistent post-COVID symptoms in PCR-negative patients confirm that the downstream pathophysiology is independent of active viral replication. Pulmonary microclots in COVID-19 are unusually rich in von Willebrand factor and platelets, differing from the typical composition of a peripheral venous embolus and suggesting in-situ formation. A post-infectious hyperinflammatory syndrome mimicking Kawasaki disease has been observed in children after COVID-19, driven by residual antibodies following viral clearance.