In a new study, researchers have made significant steps forward in understanding COVID-19.
They found a new mechanism causing blood clots in COVID-19 patients and potential ways to treat them.
The research was conducted by a team from the Lawson Health Research Institute and Western University.
A major complication occurring in most critically ill COVID-19 patients is clotting in the lung’s small blood vessels which leads to low oxygen levels in the body.
The reason for this clotting has been unclear.
Most suspect the clotting mechanisms in our blood are put into overdrive and so many clinicians have been treating with anticoagulant therapies like the drug heparin.
In the study, the team analyzed the blood samples from their 30 participants and they found that the inner linings of small blood vessels are becoming damaged and inflamed, making them a welcoming environment for platelets (small blood cells) to stick.
They discovered that COVID-19 patients had elevated levels of three molecules (hyaluronic acid, syndecan-1, and P-selectin.)
The first two molecules are products broken down from small hair-like structures (the glycocalyx) which line the inside of the blood vessels.
Their presence suggests the glycocalyx is being damaged with its breakdown products sent into the bloodstream.
The presence of P-selectin is also significant as this molecule helps to make both platelets and the inner lining of blood vessels adhere to one another.
The team says the glycocalyx keeps platelets from touching the inside wall of the blood vessel and helps facilitate the production of nitric oxide, which has an important role in preventing platelets from sticking.
They suspect the body’s immune response is producing enzymes that shear off these little hair-like structures, inflaming blood vessels and making them a welcoming environment for platelets to form clots.
The team suggests that two therapies may hold promise for treating blood clots in COVID-19 patients: platelet inhibitors to stop platelets from sticking and molecules to protect and restore the inner lining of blood vessels.
By exploring these therapies as potential alternatives to anticoagulant therapies, scientists may be able to improve patient outcomes.
One author of the study is Dr. Douglas Fraser.
The study findings are published in Critical Care Explorations.
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