Erythrocyte, Platelet, Serum Ferritin, and P-Selectin Pathophysiology Implicated in Severe Hypercoagulation and Vascular Complications in COVID-19

CITATION: Venter, C. et al. 2020. Erythrocyte, Platelet, Serum Ferritin, and P-Selectin Pathophysiology Implicated in Severe Hypercoagulation and Vascular Complications in COVID-19. International Journal of Molecular Sciences, 21(21). doi:10.3390/ijms21218234The original publication is available at https://www.mdpi.com/journal/ijmsProgressive respiratory failure is seen as a major cause of death in severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-induced infection. Relatively little is known about the associated morphologic and molecular changes in the circulation of these patients. In particular, platelet and erythrocyte pathology might result in severe vascular issues, and the manifestations may include thrombotic complications. These thrombotic pathologies may be both extrapulmonary and intrapulmonary and may be central to respiratory failure. Previously, we reported the presence of amyloid microclots in the circulation of patients with coronavirus disease 2019 (COVID-19). Here, we investigate the presence of related circulating biomarkers, including C-reactive protein (CRP), serum ferritin, and P-selectin. These biomarkers are well-known to interact with, and cause pathology to, platelets and erythrocytes. We also study the structure of platelets and erythrocytes using fluorescence microscopy (using the markers PAC-1 and CD62PE) and scanning electron microscopy. Thromboelastography and viscometry were also used to study coagulation parameters and plasma viscosity. We conclude that structural pathologies found in platelets and erythrocytes, together with spontaneously formed amyloid microclots, may be central to vascular changes observed during COVID-19 progression, including thrombotic microangiopathy, diffuse intravascular coagulation, and large-vessel thrombosis, as well as ground-glass opacities in the lungs. Consequently, this clinical snapshot of COVID-19 strongly suggests that it is also a true vascular disease and considering it as such should form an essential part of a clinical treatment regime.https://www.mdpi.com/1422-0067/21/21/8234Publishers versio

Veelvuldige gebruike vir huishoudelike toestelle

Thesis (MA)--Stellenbosch University, 2013.AFRIKAANSE OPSOMMING: Die eerste gedeelte van hierdie tesis ondersoek die ruimtelike basis vir morele agentskap in Gert Vlok Nel se digbundel om te lewe is onnatuurlik. As teoretiese raamwerk word daar van die teoloog/letterkundige Wesley Kort, die letterkundige/sosioloog Irma du Plessis en die radikale geograaf David Harvey se werk gebruik gemaak. Kwessies soos die (i) wisselwerking tussen omvattende, sosiale en intieme ruimtes deur narratiewe ruimtelikheid in poësie, (ii) die onstandvastigheid van die onderskeid tussen private en openbare ruimtes en (iii) verkillende vorms van ruimtelikheid, soos absolute, relatiewe en relasionele ruimtes, asook materiële ruimte, gerepresenteerde ruimte en ruimtes van representasie kom aan die bod. Daar word aangevoer dat Gert Vlok Nel se bewustelike plasing van homself as randfiguurdigter binne die Afrikaanse literêre sisteem as vorm van morele agentskap gesien kan word. Verder word getoon dat, as om te lewe is onnatuurlik in geheel en as familiekroniek gelees word, die onderskeid tussen private en openbare ruimtes waar geweld en trauma plaasvind ondergrawe word en sodoende politieke magskwessies as persoonliketiese kwessies herdefinieer. Laastens word argument gevoer dat, alhoewel die sprekerdigter in die bundel (“Gert”, of “Gertjie”) op die oog af gebrekkige agentskap blyk te toon, die besonderse tydruimtelike plasing van die spreker-digter die moontlikheid vir verruiming van agentskap skep en sodoende die idee van versplinterde subjek uitdaag. Hierdie akademiese opstel hou verband met die kreatiewe gedeelte van die tesis, digbundel getiteld Veelvuldige gebruike vir huishoudelike toestelle, waarin huishoudelike ruimtes as vertrekpunt gebruik word om kwessies soos morele verantwoordbaarheid, kreatiewe aandadigheid, post-koloniale manlikheid, sosiale verandering en trauma te ondersoek.ENGLISH ABSTRACT: The first part of this thesis investigates the spatial grounds for moral agency in Gert Vlok Nel’s collection of poems om te lewe is onnatuurlik [“to live is unnatural”]. The works of theologian/literary theorist Wesley Kort, literary theorist/sociologist Irma du Plessis and radical geographer David Harvey are used as theoretical framing. Matters such as (i) the interplay between encompassing, social and intimate spaces through narrative spatiality in poetry, (ii) flawed distinctions between private and public space, and (iii) different forms of spatiality, such as absolute, relative and relational space, as well as material space, represented space and spaces of representation are explored. It is argued that Gert Vlok Nel’s conscious positioning of himself as poetic outsider within the Afrikaans literary system can be seen as a form of moral agency. Furthermore, it is pointed out that a reading of om te lewe is onnatuurlik in its entirety, as family chronicle, destabilises the distinction between private and public spaces where violence and trauma occur, thereby recasting political power as questions of personal ethics. Finally it is argued that, although the narrator-poet in die collection (“Gert”, or “Gertjie”) seems to lack agency, the peculiar spatio-temporal placing of the narrator-poet nevertheless opens up room for the possibility of agency and by doing this, challenges the idea of a splintered subject. This academic essay is related to the creative part of this thesis, a collection of poems titled Veelvuldige gebruike vir huishoudelike toestelle [“Multiple uses for domestic appliances”], in which household space is used as a vantage point from which to interrogate issues such as moral responsibility, creative complicity, postcolonial masculinities, social change and trauma