Патоморфологические и молекулярно-биологические аспекты повреждения кровеносных сосудов при COVID-19

Коронавирусная инфекция COVID-19, вызванная SARS-CoV-2, связана не только с широким спектром респираторных синдромов, но и с выраженным деструктивным влиянием на кровеносные сосуды всего организма. Возраст и сопутствующая патология, предрасполагают к более тяжелому течению заболевания. В качестве общих неспецифических патоморфолологических изменений, развивающихся в кровеносных сосудах под влиянием SARS-CoV-2, можно выделить повреждение эндотелия, распространенные васкулиты и тромбозы. Для кровеносных сосудов легких помимо альтерации эндотелия и тромбоза был характерен ангиогенез по расщепляющему (инвагинационному) типу. Общим механизмом альтерации кровеносных сосудов и развития васкулопатий является прямое цитопатическое воздействие вируса на эндотелиоциты и иммуноопосредованное повреждение эндотелия, проявляющееся развитием эндотелиита, деструкцией межклеточных контактов эндотелиальных клеток, их набухаением и разобщением с базальной мембраной, сопровождающееся эндо- и периваскулярным воспалением. Молекулярно-биологические механизмы инвазии вируса вовлекают различные пути его проникновения в клетку и разнообразные формы развития воспалительного ответа с участием реакций врожденного и приобретенного иммунитета.

SARS-CoV-2, COVID-19, эндотелиоциты, васкулит, тромбоз, воспаление

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