SPEAKING OF LEAKY BLOOD VESSELS
By Jackie Deal
The information in this article comes from NPR’s partnership with Kaiser Health News.
Did you know that you have more than 60,000 miles of blood vessels? That’s veins, arteries and capillaries, the teeny, tiny end twigs on the vascular branches. 60,000 miles. Good Grief, that’s almost 30 around trips from Sutherlin, Oregon to Quartzsite, Arizona! These 60,000 miles of vessels are lined with endothelial cells. Dr. William Li, a vascular biologist, compares this lining to a “freshly resurfaced ice skating rink before a hockey game on which the players and pucks glide smoothly along. When the Corona virus damages the inside of the blood vessel and shreds the lining, that’s like the ice after a hockey game; you wind up with a situation that is really untenable for blood flow.” Sticky, damaged ice slows down pucks. And sticky, damaged endothelial cells slow the blood flow which leads to…..clots.
Endothelial cells have some very important jobs: they help prevent clotting, control blood pressure, regulate oxidative stress (more about that later) and “fend off pathogens”. (That’s germs, including the Corona virus.)
Some research indicates that blood thinners may improve outcomes in COVID-19 patients. (Now don’t rush out and buy rat poison (blood thinner) unless you want to end up with the dead rats.) Other treatments are also being studied that may help protect endothelial cells from the coronavirus. “Is that the end-all be-all to treating COVID-19? I absolutely don’t think so. There’s so many aspects of the disease that we still don’t understand,” says Dr. Seheult of the medical education website called Med Cram.
The most severe effects seem to be on “patients who are obese, people who have large BMIs, people who have Type 2 diabetes and with high blood pressure. Over time, all of those conditions can cause inflammation and damage to the lining of blood vessels,” Dr. Seheult says, “including a harmful chemical imbalance known as oxidative stress.”
“The endothelial cells get leaky, so instead of being like Saran Wrap, it turns into a sieve and then it allows fluid from the bloodstream to accumulate in the airspaces,” Harvard’s Dr. Libby says. Those airspaces are in your lungs and instead of having air they then have fluid. If thinking of the epithelial lining of your blood vessels like a hockey skating rink didn’t compute with you try the saran wrap analogy. A nice smooth slippery lining that helps the blood flow compared to a sieve that allows fluid from the blood to leak out and fill up your lungs.
Doctors who treat COVID-19 are now keenly aware that complications such as strokes and heart problems can appear, even after a patient gets better and their breathing improves. The Angiogenesis Foundation’s Dr. Li puts it this way: “The virus enters your body and it leaves your body. You might or might not have gotten sick. But is that leaving behind a trashed vascular system?” Good question! Will it take years to know? Another good question. Should we do all we can to protect ourselves and our neighbors? The most important question!