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Clinical Implications of Thrombotic Micro Vascular Angiopathy (TMA) in Severe and Critical COVID 19 Patients.

Hamza Rana, Rimsha Khalid,

Severe acute respiratory syndrome coronavirus has a great role in causing respiratory illness in humans and has the most important relationship of its spike proteins with host ACE-2 receptors. After entry into the human body, the viral S protein receptor binding domain binds to human ACE-2 receptor. Spike protein is split from the cleavage site along its two subunits S1 and S2 then during this process. S2 subunit release RBD (Receptor- Binding Domain) of S1 mediated to the ACE-2. The RBD of S1 consists of 200 amino acid domains. The sample size was of 350 patients between age 48 years+2 years. Out of these patients that were screened, 141 were classified as severe and critical stage of the disease and hence serve as subject to this focused study. The effects of this virus on platelets are rather erratic and unusual with slight decrease in the number of platelets. The raised number of d-dimers in blood of patients has been observed resulting in an elevated level of LDH.