key: cord-0779422-5mg5w458
authors: Salvatore, Mary M.
title: Pulmonary infarcts in COVID-19
date: 2021-07-23
journal: Clin Imaging
DOI: 10.1016/j.clinimag.2021.07.014
sha: 209e46d92ff5e172f6484fc0b842af62add89f5d
doc_id: 779422
cord_uid: 5mg5w458

nan

SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) receptors found on vascular endothelial cells among others (1) . Goshua et al. reported that von Willebrand factor is released by activated vascular endothelial cells and modulates platelet adhesiveness and aggregation; it was most elevated in sickest COVID-19 patients (2) . Thus, the endothelial cell infection leads to a hypercoaguable state providing a rationale for the extent of microthrombi seen in those who succumbed to the disease. Hampton's humps representing ischemic or infarcted lung are found in less than 36% of patients with pulmonary emboli who do not have COVID-19 infection (6) . The lung is spared in many patients due to its dual blood supply with a bronchial circulation that connects to the pulmonary arterial circulation and responds to ischemia by increasing its volume 300% following pulmonary embolus (7) . In contrast, Lax et al found infarcts at autopsy in 8 of

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