{
  "abstract": "Emerging and re-emerging RNA viruses frequently present with clinical phenotypes that extend beyond classical organ tropism and include vascular leakage, platelet dysregulation, coagulation imbalance, microvascular injury, and thromboinflammation. SARS-CoV-2, flaviviruses, and hantaviruses provide three complementary models of virus-induced vascular disease. This narrative review compares these viruses through a shared endothelial-coagulative framework and proposes four partially overlapping vascular programs: endothelial activation, endothelial barrier failure, coagulation activation, and platelet quantitative or qualitative dysfunction. These programs are intended as a conceptual synthesis of convergent clinical, pathological, and experimental evidence rather than as a quantitative classification system. The framework is used not only to organize known mechanisms, but also to generate testable predictions for cross-virus biomarker panels, organ-specific endothelial models, and phenotype-guided clinical studies. Severe COVID-19 illustrates inflammation-driven endothelial activation, platelet-leukocyte interactions, complement amplification, NETosis, and immunothrombosis. Within the flavivirus group, DENV is used as the principal model for systemic vascular leakage, thrombocytopenia, and hemorrhagic risk; selected non-dengue flaviviruses illustrate how shared endothelial, platelet, and coagulation modules are redirected toward placental dysfunction (ZIKV), neuroinvasion (WNV and JEV), or hepatic failure and coagulopathy (YFV). Hantavirus infections provide a distinctive model of capillary leak syndrome in which non-lytic endothelial infection, immune-mediated injury, and permeability signaling converge on renal and pulmonary microvascular beds. A comparative view suggests that thrombotic, hemorrhagic, and leaky phenotypes are not mutually exclusive categories, but different outcomes of overlapping vascular programs shaped by viral tropism, vascular-bed specialization, immune activation, and host susceptibility.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy.",
    "Department of Life Sciences, University of Ferrara, 44121 Ferrara, Italy."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Silvia Beltrami",
      "orcid": "0000-0002-5923-9265"
    },
    {
      "affs": [
        0
      ],
      "name": "Giovanni Strazzabosco",
      "orcid": "0000-0001-7227-7939"
    },
    {
      "affs": [
        0
      ],
      "name": "Giovanna Schiuma",
      "orcid": "0000-0003-4652-5550"
    },
    {
      "affs": [
        0
      ],
      "name": "Sabrina Rizzo",
      "orcid": "0000-0002-9246-136X"
    },
    {
      "affs": [
        1
      ],
      "name": "Marcello Baroni",
      "orcid": "0000-0002-2659-6362"
    },
    {
      "affs": [
        0
      ],
      "name": "Daria Bortolotti",
      "orcid": "0000-0003-4496-9561"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/84g61de2j48pq.bib",
  "cited_by": 0,
  "doi": "10.3390/v18101160",
  "fulltext_url": "https://europepmc.org/articles/PMC13709913",
  "id": "84g61de2j48pq",
  "issns": [
    "1999-4915"
  ],
  "landing_url": "https://europepmc.org/article/MED/42944079",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Viral Infections and Vectors"
    ]
  ],
  "openalex": "W7222960968",
  "pdf_url": "https://europepmc.org/articles/PMC13709913?pdf=render",
  "pmcid": "PMC13709913",
  "pmid": "42944079",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/84g61de2j48pq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:12Z",
      "native_id": "MED:42944079",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42944079"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Viral Infections and Vectors",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Vascular Programs in Emerging and Re-Emerging RNA Virus Infections: Comparative Lessons from SARS-CoV-2, Flaviviruses, and Hantaviruses.",
  "title_text": "Vascular Programs in Emerging and Re-Emerging RNA Virus Infections: Comparative Lessons from SARS-CoV-2, Flaviviruses, and Hantaviruses.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/84g61de2j48pq",
  "venue": "Viruses",
  "versions": []
}