The COVID-19 pandemic has caused monumental mortality, and there are still no adequate therapies. Most severely ill COVID-19 patients manifest a hyperactivated immune response, instigated by interleukin 6 (IL6) that triggers a so called “cytokine storm” and coagulopathy. Hypoxia is also associated with COVID-19. So far overlooked is the fact that both IL6 and hypoxia depress the abundance of a key anticoagulant, Protein S. We speculate that the IL6-driven cytokine explosion plus hypoxemia causes a severe drop in Protein S level that exacerbates the thrombotic risk in COVID-19 patients. Here we highlight a mechanism by which the IL6-hypoxia curse causes a deadly hypercoagulable state in COVID-19 patients, and we suggest a path to therapy.
【저자키워드】 COVID-19, ACE2, Cytokine storm, hypoxia, IL6, Coagulopathy, protein S, 【초록키워드】 immune response, therapy, Mortality, COVID-19 pandemic, cytokine, Hypoxemia, mechanism, COVID-19 patients, Therapies, Anticoagulant, COVID-19 patient, Trigger, hypercoagulable, MOST, thrombotic risk, highlight, caused, cause, exacerbate, “cytokine storm”, with COVID-19, 【제목키워드】 Anticoagulant,