[ad_1]
04/20/2020 – Senior web editor
04/20/2020
Senior web editor
COVID-19: also a systemic vascular inflammation
COVID-19 became known as a lung disease. Until now it has not been clear why patients also experience life-threatening failure of other organs. An interdisciplinary team at the Zurich University Hospital has shown that SARS-CoV-2 triggers inflammation in the vessels and can lead to organ failure and death.
The first seriously ill COVID-19 patients suffered primarily from difficult-to-treat viral pneumonia as a complication. A typical disease of coronaviruses because they mainly attack the respiratory tract. However, doctors found that an increasing number of patients also exhibited cardiovascular problems or multi-organ failure. It was unclear if there was any connection to the pneumonia. Since older patients were particularly affected, doctors assumed that exposure to the disease triggered cardiovascular problems in the typical age group.
Changes and SARS-VOC-2 on all ships
Examining tissue samples from deceased patients with COVID-19 after an autopsy, pathologists at the University of Zurich Hospital now noted that patients not only suffered from inflammation of the lungs, but that the inflammation affected the entire endothelium of several organs. Additionally, pathologist Prof. Zsuzsanna Varga was able to use the electron microscope to detect SARS-CoV-2 for the first time directly in the endothelium and cell death caused by the virus there.
The endothelium is a cell layer that forms a kind of protective shield in the vessels and regulates and balances various processes in the micro vessels. If this regulatory process is altered, this can trigger, for example, circulatory disorders in the organs or tissues of the body, leading to cell death and therefore death of these organs or tissues.
Attack of the virus in the defense of the body.
The researchers concluded that the virus does not directly attack the body’s defense through the lungs, but through the ACE2 receptors found in the endothelium, spreading over it and causing widespread inflammation in the endothelium, stopping its protective function. bring. Therefore, the virus not only triggers pneumonia, which then causes additional complications, but also direct systemic endotheliitis, an inflammation of the entire endothelium in the body that affects all vascular beds – cardiac, brain, lung, and kidney vessels, as well as to vessels in the Intestinal Tract With fatal consequences: Serious microcirculation disorders arise that damage the heart, trigger pulmonary embolism and vascular occlusion in the brain and intestinal tract, and can lead to multi-organ failure and even death.
The endothelium of younger patients is generally well adapted to virus attack. The situation is different for patients suffering from high blood pressure, diabetes, heart failure, or coronary heart disease; Diseases that have in common that limit endothelial function. SARS-COV-2 infection is particularly dangerous for these patients because weakened endothelial function continues to decline, especially in the phase when the virus multiplies more.
Rescue high-risk patients with double therapy.
“With our research we were able to test our hypothesis that COVID-19 can affect not only the lungs but also the vessels of all the organs. COVID is a systemic vascular inflammation, we should now describe the clinical picture as COVID endotheliitis “, summarizes Professor Frank Ruschitzka, Director of the Cardiology Clinic, the findings contributed by cardiologists, infectologists, pathologists and intensive care physicians .
For Frank Ruschitzka, this also means that therapy for COVID-19 patients must start at two points: “We have to inhibit the multiplication of viruses in their most proliferating phase and at the same time protect and stabilize the patient’s vascular system. This particularly affects our patients with cardiovascular disease and known restricted endothelial function, as well as the known risk factors for a severe course of COVID-19. “
[ad_2]
