The potential for a rapid increase in severity is among the most frightening aspects of severe acute respiratory syndrome coronavirus 2 infection. Evidence increasingly suggests that the symptoms of coronavirus disease‐2019 (COVID‐19)‐related acute respiratory distress syndrome (ARDS) differ from those of classic ARDS. Recently, the severity of COVID‐19 has been attributed to a systemic, thrombotic, and inflammatory disease that damages not only the lungs but also multiple organs, including the heart, brain, toes, and liver. This systemic form of COVID‐19 may be due to inflammation and vascular endothelial cell injury. The vascular endothelial glycocalyx comprises glycoproteins and plays an important role in systemic capillary homeostasis maintenance. The glycocalyx covers the entire vascular endothelium, and its thickness varies among organs. The endothelial glycocalyx is very thin in the pulmonary capillaries, where it is affected by gaseous exchange with the alveoli and the low intravascular pressure in the pulmonary circulation. Despite the clearly important roles of the glycocalyx in vascular endothelial injury, thrombosis, vasculitis, and inflammation, the link between this structure and vascular endothelial cell dysfunction in COVID‐19 remains unclear. In this prospective review, we summarize the importance of the glycocalyx and its potential as a therapeutic target in cases of systemic COVID‐19.

中文翻译：

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血管内皮损伤加剧了 2019 年冠状病毒病：内皮糖萼保护的作用

严重急性呼吸综合征冠状病毒 2 感染最可怕的方面之一是严重程度迅速增加的可能性。越来越多的证据表明，2019 冠状病毒病 (COVID-19) 相关的急性呼吸窘迫综合征 (ARDS) 的症状与经典 ARDS 的症状不同。最近，COVID-19 的严重性归因于一种全身性、血栓性和炎症性疾病，这种疾病不仅会损害肺部，还会损害包括心脏、大脑、脚趾和肝脏在内的多个器官。这种全身形式的 COVID-19 可能是由于炎症和血管内皮细胞损伤所致。血管内皮糖萼包含糖蛋白，在全身毛细血管稳态维持中起重要作用。糖萼覆盖整个血管内皮，其厚度因器官而异。肺毛细血管中的内皮糖萼非常薄，受与肺泡的气体交换和肺循环中低血管内压的影响。尽管糖萼在血管内皮损伤、血栓形成、血管炎和炎症中具有明显的重要作用，但这种结构与 COVID-19 中血管内皮细胞功能障碍之间的联系仍不清楚。在这篇前瞻性综述中，我们总结了糖萼的重要性及其作为全身性 COVID-19 治疗靶点的潜力。血管炎和炎症，这种结构与 COVID-19 中血管内皮细胞功能障碍之间的联系仍不清楚。在这篇前瞻性综述中，我们总结了糖萼的重要性及其作为全身性 COVID-19 治疗靶点的潜力。血管炎和炎症，这种结构与 COVID-19 中血管内皮细胞功能障碍之间的联系仍不清楚。在这篇前瞻性综述中，我们总结了糖萼的重要性及其作为全身性 COVID-19 治疗靶点的潜力。