Abstract: Objective To review the mechanism of immunethrombosis in highly pathogenic coronavirus（HPCoVs）infections and provide reference for clinical prevention and treatment. Methods Domestic and foreign literature was reviewed to outline the pathogenic mechanism of host immunethrombosis caused by Hcov in terms of coagulation disorders, immune/inflammatory disorders, endothelial cell injury/dysfunction, and platelet disorders. Results The uncontrolled immunethrombosis caused by Hcov infections was related to cytokine storm, formation of neutrophil extracellular traps, excessive activation of the complement system and renin-angiotensin system, oxidative stress of endothelial cells and glycocalyx damage, which were the leading causes of critical illness and death of patients. Conclusion An in-depth study of the pathogenesis of immunethrombosis due to highly pathogenic coronavirus infections and the development and evaluation of potential therapeutic interventions could not only mitigate the acute and long-term consequences of the disease, but also have significant implications for future responses to other emerging and emergent infectious diseases.

Key words: highly pathogenic, coronavirus infection, immune thrombosis, hyperinflammation, endothelial damage, coagulation system activation