Analysis of tissues from COVID-19 fatalities reveals the virus directly inflames blood vessels, potentially causing multi-organ failure and death.
Initially viewed as a primarily respiratory illness—with the lungs as the main target—COVID-19 has increasingly been linked to fatalities from cardiovascular complications or multi-organ failure, not just lung collapse.
Researchers led by Professor Zsuzsanna Varga at University Hospital Zurich (Switzerland) microscopically examined tissues from three deceased patients (men aged 69 and 71, and a 58-year-old woman). They discovered endothelial inflammation throughout the body. Their findings were published in The Lancet.
The endothelium forms the innermost lining of blood vessels, acting as a protective barrier in direct contact with blood. Disruption here triggers circulatory issues, leading to cell death and organ failure.
SARS-CoV-2 binds to ACE2 receptors on cell surfaces to infect hosts. This University of Zurich study shows the virus targets these receptors directly on endothelial cells—bypassing initial lung focus—compromising the endothelium's protective role.
"Patients suffer not only lung inflammation but systemic vascular inflammation, which damages the heart, brain, lungs, kidneys, and intestines," explains co-author Prof. Frank Ruschitzka, head of the hospital's cardiology department.
Individuals with hypertension, diabetes, heart failure, or coronary artery disease often have impaired endothelial function, explaining their heightened vulnerability.
Prof. Ruschitzka emphasizes treating viral replication while protecting and stabilizing the vascular system.
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