Science lives on as the discipline which never runs out of questions, especially for COVID19. While true for every worthy scientific endeavor, the persisting syndrome of Long Hauler COVID promises a litany of questions to answer for years to come. The acute disease was threatening enough, but the ongoing symptoms for many with Long Hauler COVID leaves many looking for answers which lead to full recovery from the hated virus of 2020. One of the developing answers points towards inflammation of the cells lining the blood vessels.
The SARS-CoV2 coronavirus behind COVID, like other viruses, targets specific cells which contain receptors or other entry points for the invasion. SARS-CoV2 primarily affects lung cells through a receptor for ACE2 but also damages other cells with this receptor. The symptoms make sense in the acute disease, but with the virus supposedly gone at the end of acute symptoms, why do long haulers continue to have symptoms?
The term long haulers was coined to describe the syndrome of prolonged symptoms experienced for a large percentage of COVID 19 patients. The symptoms cross many systems include pulmonary, neurologic, cardiac, and energy production. So far, we see some patients continuing for weeks and months of sometimes debilitating symptoms. The virus cannot be found, but symptoms are undeniable. Lab tests which explain the mechanisms for the symptoms or point to means of treating it are lacking.
Scientists love answering questions, so many are searching for explanations to the delayed blood clots and other symptoms of Long Haulers. The group behind today’s focus article believe that ongoing inflammation of the blood vessel walls lies behind the blood clotting found in some patients. Normally, the cells called endothelium stay in place lining the blood vessel tubes and control what comes in and out of nearby tissues. With the Long Hauler patients, they demonstrated a higher number of circulating, or free floating, endothelial cells.
Besides the higher cell numbers, they also demonstrated higher levels of several cytokines. As our Immune Prepper course describes in more detail, these cytokines are chemicals released by immune cells to influence other immune cells and organize a response to an invader. The pattern of cytokine elevation for the Long Hauler patients indicates ongoing inflammation.
Between the direct damage to the endothelial cells lining the blood vessels and the increased inflammation, this provides a perfect opportunity to trigger a blood clot. These clots may occur in the brain, the heart, or more peripheral tissues. Obviously clots in any of these locations could lead to illness or even death.
As this plot unfolds, I expect to see more links between unrelenting inflammation and the symptoms of Long Hauler COVID. So far, our patients complaining of Post COVID seem to respond relatively well to the anti-inflammatories both oral and IV that we have been using. Combining this with optimizing their metabolic health and stabilizing other immune parameters seems to restore them to normal faster.
Helping others live healthier more abundant lives means both understanding the root causes better through good lab research AND applying those with wisdom. Grab your popcorn and watch for the sequel to this exciting research.
Florence WJ Chioh, Siew-Wai Fong, Barnaby E Young, Kan-Xing Wu, Anthony Siau, Shuba Krishnan, Yi-Hao Chan, Guillaume Carissimo, Louis LY Teo, Fei Gao, Ru San Tan, Liang Zhong, Angela S Koh, Seow-Yen Tan, Paul A Tambyah, Laurent Renia, Lisa FP Ng, David C Lye, Christine Cheung. Convalescent COVID-19 patients are susceptible to endothelial dysfunction due to persistent immune activation. eLife, 2021; 10 DOI: 10.7554/eLife.64909
Thanks to Science Daily:
eLife. “Prolonged immune response may contribute to post-COVID-19 blood clots.” ScienceDaily. ScienceDaily, 23 March 2021. <www.sciencedaily.com/releases/2021/03/210323103843.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.