Although the coronavirus was originally defined as a lung disease when it first appeared, it is now known that it affects almost all organ systems in the body, especially vascular involvement, with the recognition of the disease over time. Especially with the definition of vascular involvement, it is seen that more effective results are started to be obtained in the fight against this virus. It was known that Covid-19 first entered the body with ACE2 receptors, which are dense in the lungs. Therefore, the first focus was on the lungs. However, another region where ACE2 receptors are concentrated is endothelial cells that surround the inner surface of all blood vessels like a Teflon coating. Widespread vascular disease may occur as a result of the involvement of these cells by the virus.
Coagulation may be due to Covid-19
Today, it has been revealed that the situation that makes Covid-19 deadly is the endothelial damage in the vessels and, accordingly, intense coagulation in the blood. The use of drugs known as heparin and its derivatives against coagulation in the treatment plays an active role in the fight against the disease. As a result, fatal complications due to vascular damage can be minimized in the treatment of patients.
However, it is not known who will have this disease more severely and who will have it milder. According to studies, patients with hypertension, diabetes and cardiovascular system have a higher risk of having the disease more severely when they get Covid-19. This may be due to the fact that vascular structures are even more susceptible to endothelial damage. The endothelium is a special tissue composed of a single row of cells. In cardiovascular surgery, extreme sensitivity is used to avoid touching the endothelium while suturing the vessels. Because even the smallest mistake can cause vascular damage. At the same time, the endothelium prevents the contact of the muscle cells and the fat layer that form the wall of the vessel with the flowing blood. The contact of the flowing blood with the cells of the layers other than the endothelium causes the blood to clot.
High inflammation with coronavirus
“Hyperinflammatory syndrome” also occurs with Covid-19. That is, an inflammation is developing far above normal. When this situation is common in the lungs, even if a high amount of oxygen is given to the patient, sufficient oxygen cannot be provided to the body, that is, to all tissues and organs, since there is no blood to receive that oxygen in return. With the excessive increase in inflammation, the veins completely lose their function and begin to leak fluid. Leakage of fluid outside the vein causes fluid to accumulate in the lungs. This is the reason why, in addition to the PCR test, a chest X-ray or tomography is taken when the first diagnosis is made in patients who have experienced Covid-19 with obvious symptoms and have shortness of breath.
holding the heart muscle
It is known that the Covid-19 virus infects the heart muscle and surrounding cells (Pericytes).
Severe heart muscle damage and vascular deterioration can be seen in patients with coronavirus. In some studies; even if there is no clinical problem in the heart of the patient, it is seen that around 75 percent of the heart muscle is involved. Especially with certain risks; It has been shown that in people with coronary artery disease, the plaque that creates the stenosis can suddenly burst and cause a crisis by blocking the heart vessel, even in non-critical stenosis due to increased vascular damage.
Blood thinners should be used with caution
People with coronary artery disease with Covid-19 are recommended to use blood thinners. Since life-long use of aspirin or other blood thinners is recommended in most of the already known coronary artery patients, it is recommended that patients who are already using it should continue and consult their physician about an additional recommendation by informing them that they are Covid. It is necessary to pay attention to the use of blood thinners. In addition to saving lives, blood thinners also have certain risks; It can cause bleeding in the body. For this reason, it is of vital importance that blood thinners be used as recommended by the doctor and that people do not take such drugs indiscriminately.
It also affects the veins
Similar situations can be seen in the vein system as well as in the arterial system. It is seen that the coagulation in the vein, which we call “deep vein thrombosis”, and the removal of that clot and throwing it into the lungs in the form of a clot, that is, the events called “Pulmonary embolism” increase more significantly. It has been reported that deep vein thrombosis can be seen in 25% and pulmonary embolism in 20%, especially in patients hospitalized due to Covid-19. In hospitalized patients, blood thinners should be used, especially in the form of injections.
Plenty of fluids should be consumed
Over time, as scientific research increases and the effects of Covid-19 become familiar, it is seen that serious damage can occur to the endothelial cells in the vessels. However, damage and coagulation occur in all vascular systems in the body. Adequate water consumption is extremely important in order to prevent clotting that may occur in the veins. As the blood will thicken with fluid loss, slow flow and increased clotting risk invite cardiovascular diseases. Fluid consumption dilutes the blood and prevents a possible clotting. Water consumption is important at this point when fighting the Covid-19 virus. Therefore, it is necessary to consume plenty of water during and after the coronavirus disease.