GENOA (Pakistan Point News / Sputnik - 09th June, 2020) COVID-19 may be a combination of a respiratory and an a vascular infection that has the ability to trigger an exaggerated response from the body's immune system, eventually destroying the cells independently from the virus' concentration, Luca Testa, the head of the Coronary Revascularisation Unit and head of the Clinical Research Unit at The Policlinico San Donato Research Hospital, which is the largest and most renowned Italian center specialized in the field of cardiovascular treatments, told Sputnik.
"We cannot say it's purely a respiratory infection or purely a vascular infection. The truth is in between... Definitely this virus has capacities to target the vascular bed, but it gets to the vessels through the respiratory channels," Testa said.
Last week, a group of molecular biologists from Germany stated in their research published on the bioRxiv preprint server that the SARS-CoV-2 virus can directly affect cardiac cells and reproduce in cardiac tissues of certain COVID-19 patients.
"It causes an inflammatory process in the vessels, reaction of our immune system to the virus. The major problem seems to be not actually the presence of the virus but the answer of the immune system to the virus. It seems like the virus is able to trigger and to exaggerate the response of the immune system. This exaggerated response, in particular to the lungs, is able to destroy the lungs and to destroy the blood vessels," Testa said.
Thus, the researchers observe "some patterns of autoimmunity" in the COVID-19 patients, according to Testa.
"This is a possible explanation of why this virus is so weak in very young humans. Because at this age our immune system is not so powerful to react in such a manner, it is not able to destroy the lungs and destroy ourselves," he continued, adding that these were just observations.
In April, a group of researchers from the University Hospital Zurich published a study claiming that the COVID-19 disease is more of a systemic vascular inflammation rather than pneumonia and that the novel coronavirus attacks the lining of blood vessels across the body.
Since April, a number of scientific studies and publications emphasized that a high number of COVID-19 deaths were related to cardiovascular complications. In particular, Circulation Research published in AHA Journals in May says it reaches 40 percent, making the disease look like a vascular infection.
The effect of coronavirus on children apparently manifests in the cardiovascular system as well. In May, a study was published in Italy claiming a monthly incidence of Kawasaki-like disease cases in children in the Bergamo province was at least 30 times greater than the monthly incidence of the previous 5 years. It stated there was a "clear starting point" after the first case of COVID-19 was diagnosed in the area.
"Kawasaki-like syndrome is consistent to what I have said, because this syndrome is related to the inflammatory response and because this virus is able to trigger an inflammatory response. The major problem is related to the fact that our body tends to react, but this reaction is exaggerated, and it turns into damage instead of protection," Testa said.
Although there is a big debate going on as to what the medical treatment of COVID-19 should be, it is clear that drugs that tend to reduce the inflammatory response seem to be working, according to the cardiologist. Also, the role of anticoagulants proves to be very important, as they prevent or at least reduce the risk of cardiac complications.
"We need to admit that this disease is really young, we know COVID-19 since six months ago, and this is the reason why we are still debating what should be the treatment and approach. There is still a long way to go to understand what the mechanism behind this pathology is. All we can say is still preliminary. We need to have more data and more high-quality studies. Too many studies are just unreliable. We are still learning," Testa said.
The growth in the Kawasaki-like syndrome, affecting young children and causing heart and kidney failure, was also detected in other countries, including the United States, the United Kingdom, Germany, Spain and Switzerland. It was classified as Pediatric Multi-System Inflammatory Syndrome (PMIS).
