According to Swiss doctors, they found direct evidence that coronavirus attacks the endothelial cells of the body. They confirmed that people with high blood pressure, hypertension, and other cardiovascular diseases are particularly vulnerable to Covid-19.
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When the Chinese authorities on New Year’s Eve reported the first cases of infection with a new virus, it was precisely about “pneumonia of unknown origin.” Later, the PRC presented the first autopsy results of one of the patients who died from Covid-19, which stated that the disease affects mainly the lungs. However, since then, specialists around the world have made significant advances in the study of Covid-19 and the damage this infection does to the patient.
So, a group of scientists from the University Hospital Zurich (Switzerland), which published a new study, claims that coronavirus disease causes harm not only to the lungs: it attacks the endothelium, the entire network of blood vessels and ultimately leads to multiple organ failure – a serious general disease of the body, which is characterized by violation of the functioning of two or more of its systems. In addition, the virus causes serious microcirculatory disorders that can damage the heart, provoke a pulmonary embolism or obstruct the passage of blood vessels in the brain or gastrointestinal tract.
To confirm their findings, doctors using an electron microscope examined the blood vessel cells of three patients with coronavirus – two men aged 71 and 69 years, as well as a 58-year-old woman. So, the first of them had a history of coronary heart disease and arterial hypertension. After the diagnosis of coronavirus disease, his condition worsened, the man required mechanical ventilation. Multisystem organ failure began, and on the eighth day the patient died. Post-mortem analysis by electron microscopy revealed traces of viral inclusions in endothelial cells (a thin, semi-permeable membrane lining all blood and lymph vessels, as well as cardiac cavities). In the lungs of the deceased, doctors discovered an accumulation of mononuclear cells, in addition, most of the small vessels in these organs were stagnant.
The second patient, a woman, had diabetes, she also had arterial hypertension and obesity. Due to coronavirus, progressive respiratory failure developed, and then multiple organ failure, and therefore renal replacement therapy was required. Due to mesenteric ischemia, a woman began to have small bowel necrosis, and doctors removed it. In addition, due to poor blood circulation and heart failure, the patient suffered a heart attack. As a result, she died of cardiac arrest. Post-mortem histology revealed endotheliitis (endotheliitis) of the lungs, heart, kidneys and liver.
The last patient – a 69-year-old man – had hypertension, and because of Covid-19, respiratory failure began, and mechanical ventilation was required. Echocardiography showed a reduced ejection fraction (an indicator reflecting the volume of ejected blood) of the left ventricle. Circulatory disorders were accompanied by mesenteric ischemia, so the patient had a small bowel resection. He also revealed pronounced endothelitis of the submucosal vessels.
“Coronavirus enters the endothelium, which serves as a protective line of blood vessels. This weakens the body’s defense system and causes problems in microcirculation. We found direct evidence that a viral infection infects endothelial cells and leads to diffuse endothelial inflammation. Although the virus uses the ACE2 enzyme expressed by pneumocytes in the epithelial alveolar membrane to infect the host, thereby causing lung damage, ACE2 is also widely expressed on endothelial cells that cross several organs, ”the authors write.
From all of the above, researchers conclude that virus particles are present in endothelial cells, as a result of the disease it is able to affect many organs, including the heart, kidneys and intestines.
“Our hypothesis explains the importance of therapy for endothelial stabilization. Such a treatment strategy may be especially relevant for vulnerable patients who suffer from endothelial dysfunction. This is especially true for men, smokers, patients with hypertension, diabetes, obesity and cardiovascular diseases, which are associated with adverse outcomes with Covid-19, ”conclude the authors of the study.
Previously, scientists talked about the similarities of patients who died from coronavirus, and also determined why obese people tolerate Covid-19 worse.
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