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Endre Szvetnik By Endre Szvetnik • June 17, 2020

How SARS-CoV-2 can make arteries malfunction and cause more severe COVID-19?

Scientists are investigating how the malfunctioning of the cells lining our blood vessels can make COVID-19 more severe for patients. An alarmingly high proportion of COVID-19 patients in intensive care units - 31% according to this study - have experienced blood clotting complications that can lead to strokes or heart attacks.

heart-vessels

Clotting can be caused by the faulty functioning of the endothelium, the smooth tissue in the walls of our blood vessels. Researchers are suggesting that strokes and heart attacks are happening to certain COVID-19 patients because endothelial cells, with a large number of ACE2 enzymes on their surfaces (the entry points for the virus), are a key target of the SARS-CoV-2. Researchers have found an elevated presence of a blood clotting molecule known as the von Willebrand Factor (vWF) in COVID-19 patients’ blood, supporting the theory that the virus is provoking endothelial malfunction. Normally, the endothelium regulates blood clotting but the hypothesis is that COVID-19 interferes with this function. As a result, the endothelium does not put a brake on blood clotting and increased vWF-levels indicate this. According to one, so far unproven theory excess blood clots appear after the virus enters endothelial cells and disrupts the communication between them and the blood components involved in clotting.

Is there a way to prevent SARS-CoV-2-induced blood clotting? A new UK trial is testing just this. Researchers are looking to find out if a drug molecule, TRV027, can prevent clotting by restoring the balance between two hormones (angiotensin II and angiotensin 1-7) that becomes disrupted with SARS-CoV-2 infection. The balance is normally maintained by ACE2 but – as mentioned above – SARS-CoV-2 attacks exactly this enzyme to enter human cells. As a result, the blood becomes very sticky and prone to clotting. Scientists believe that restoring the equilibrium between the two hormones through a drug can dampen down the destructive ability of the virus.

Here is the current state of science on a Sparrho pinboard. NB: The pinboard contains research papers that have not been peer-reviewed yet, meaning that they have not gone through the standard scientific validation process yet.

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