Erythrocytes as a Target of Sars Cov-2 in Pathogenesis of Covid-19

Abstract

The paper considers the possible mechanism of the pathogenesis of COVID-19 caused by SARS-COV-2, associated with damage to red blood cells, which the authors attribute to the main key target that triggers a cascade of reactions leading to multiple organ failure. The paper presents morphological evidence for the presence of pathological forms of erythrocytes characteristic of various anemias in the blood vessels and parenchyma of damaged lungs of patients with COVID-19. The death of red blood cells leads to cell ischemia and anemia. The defeat of brain neurons, blood vessels and hematotissue barriers in organ systems is a consequence of ischemia due to the impossibility of transferring hemoglobin by damaged erythrocytes and ends at the terminal stages of the development of the disease with their dysfunction. Adaptive erythropoiesis with an increase in erythropoietin secretion is especially dangerous for patients suffering from hypertension, and then it is impossible, since all organs involved in the synthesis of erythropoietin are damaged. In this case, the synthesis of hemoglobin is also disrupted due to a deficiency of iron and cyancobolamin, whereas toxic iron and hemosiderin are deposited in the tissues. K E y w o r d s-COVID-19, SARS-COV-2, erythrocytes, hemoglobin, erythropoiesis, viruses, pathogenesis of COVID-19.

Erythrocytes as Biomarkers of Virus and Bacteria in View of Metal Ion Homeostasis

“…Respiratory failure is the most common direct cause of death in Covid-19 patients [33,34]. Studies have reported the nuclear remnants called Howell-Jolly bodies, or seemingly fully nucleated erythrocytes in Covid-19 patients [35,36]. Nucleated erythrocytes indicate a bad prognosis and often occurs in critically ill patients in several diseases [37].…”

SARS-CoV-2 and Plasmodium falciparum are probably adopting Analogous strategy to invade erythrocytes

“…However, other suggestion in support of the Liu and Li hypothesis is already proclaimed, in which the attack of SARS-CoV-2 to the marrow’s immature erythrocytes (contain a nucleus) is hypothesized [ 26 ]. This data has been recently substantiated by investigating COVID-19 patients’ RBCs in which deformed erythrocytes with sickled shape and vacuolization of the cytoplasm that customarily induced by viruses attack were spotted [ 27 ]. Furthermore, a very recent study put forward by an English research group has proven a direct infection of erythroid progenitors by SARS-CoV-2 at severe stages of the disease [ 28 ].…”

Постковидный Синдром

“…Способность поражать внутренние органы организма даже после выздоровления, так называемый отложенный эффект ученые изучили на биологическом материале свыше 100 умерших от коронавируса пациентов [5]. В результате они сделали вывод, что вирус способен атаковать и красный костный мозг.…”

“…«Мы предполагаем, что главной целью для вируса становится красный костный мозг, где он повреждает эндотелий, в норме регулирующий миграцию созревающих эритроцитов в кровь. Именно по этой причине с клетками иммунитета происходят «страшные вещи», а в тканях разных органов появляются мегакариоциты -очень крупные клетки костного мозга» [5].…”

“…Зато есть четкое морфологическое описание. Это тромбоваскулит как вариант распространенного диссеминированного внутрисосудистого свертывания крови с поражением капилляров, мелких сосудов, с множественными микротромбами и мелкими кровоизлияниями, с выраженным отеком тканей и дистрофией нейронов в головном мозге [5,13].…”