Scientists from Zurich as a result of research concluded that the target of the new COVID-19 virus is not only the lungs. They found evidence that the infection affects the endothelium, which protects the blood vessels, and therefore all organs can be affected.
The endothelium is a special cell lining the inner surface of the blood, lymphatic vessels and cardiac cavities. For the normal functioning of various body systems, including the nervous one, it is important that they fully receive nutrients through the bloodstream. Therefore, the condition of all vessels, from large to the smallest, namely, their inner surface, the endothelium, is so important.
In the endothelium, a large number of biologically active substances are produced that are necessary for the blood coagulation process, regulation of vascular tone, stabilization of blood pressure, brain metabolism, and filtration function of the kidneys. Myocardial contractility depends on the condition of the endothelium.
Coronavirus infects this important part of the vessels, causing multiple organ failure in the carrier, scientists say in a paper published in the journal Lancet. They cite the data of their study on the example of studying the victims of the disease. Thus, in a histological examination of the organs of a 71-year-old man with coronary heart disease and arterial hypertension, researchers found an accumulation of inflammatory cells associated with endothelium in the heart, small intestine, and lungs. A 58-year-old woman with diabetes mellitus, arterial hypertension and obesity revealed lymphocytic endothelitis in the lungs, heart, kidneys and liver, as well as liver cell necrosis.
An autopsy revealed that the vascular endothelial cells were filled with a virus that interrupted their function.
Endothelial dysfunction is the main determinant of microvascular dysfunction, leading to organ ischemia, inflammation and tissue edema.
SARS-CoV-2 infects the host with the ACE2 receptor, which is expressed in several organs, including the lungs, heart, kidneys, and intestines, as well as endothelial cells. Through the vessels, the virus can immediately infect several organs, which leads to a wide spread of endothelial dysfunction.
The new hypothesis provides the rationale for therapy to stabilize the endothelium in the fight against viral replication. This strategy may be especially relevant for vulnerable patients with pre-existing endothelial dysfunction, which is associated with hypertension, diabetes, obesity and cardiovascular disease.
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