“Cardiovascular complications are rapidly emerging as a key threat in coronavirus disease 2019 (COVID-19) in addition to respiratory disease.” With these words, the Swiss cardiologist Prof. Dr. Frank Ruschitzka and several colleagues open Endothelial cell infection and endotheliitis in COVID-19, an article published on 2 May 2020, in the medical journal The Lancet. In their article, the researchers describe the detailed investigation of the “pathology of endothelial cell dysfunction” of patients who had succumbed to COVID-19. [I]
Unstoppable “wildfire” attacks endothelial cells
The endothelium is the thin layer of cells that line the entire vascular system, including, of course, the blood vessels in the lungs. Dr. Ruschitzka’s scientific team showed “the presence of viral elements within endothelial cells and an accumulation of inflammatory cells, with evidence of endothelial and inflammatory cell death. These findings suggest that SARS-CoV-2 infection facilitates the induction of endotheliitis in several organs as a direct consequence of viral involvement […] and of the host inflammatory response.” This, in turn leads to the induction of “apoptosis,” which is the self-destruction of cells, and to a process known as “pyroptosis,” which is a highly inflammatory form of programmed cell death. Pyroptosis occurs when immune cells recognize within themselves foreign danger signals, such as viral components. The cells respond by inflaming, as if they set themselves on fire. They swell, burst and die. The inflammatory compounds attract other immune cells to fight the viral infection and thus cause more inflammation in the tissue. According to the Rutschitzka team, “organized cell death and pyroptosis might have an important role in endothelial cell injury in patients with COVID-19.”
What’s Endotheliitis ?
Just like bronchitis means inflammation of the bronchi and gastritis means inflammation of the stomach, endotheliitis means inflammation of the endothelium. According to the Rutschitzka team, “COVID-19-endotheliitis” could explain the impaired microcirculatory function throughout the entire body and the deleterious effects of this endothelial impairment in patients with COVID-19. This is especially relevant in vulnerable patients with preexisting endothelial dysfunction, which is associated with male sex, smoking, hypertension, diabetes, obesity, and established cardiovascular disease, all of which are associated with adverse outcomes in COVID-19. In a follow-up Lancet article, Electron microscopy of SARS-CoV-2: a challenging task, published on 19 May, the Swiss-American team confirmed that the framework of endotheliitis provides an explanation for the unique predominance of severe acute respiratory syndrome in these groups of people. Besides this, “COVID-19-endotheliitis could also explain impaired microcirculatory function across different organs and the frequently observed prothrombotic state with [local] clot formation.” [ii]
Endotheliitis and Blood Clots
In his recently published blog-article How does COVID kill people?, the Scottish medical practititoner Dr. Malcolm Kendrick explains the omnipresent blood-clotting phenomenon in COVID patients. “This overall process is known as Disseminated Intravascular Coagulation (DIC). DIC, by blocking and damaging a high percentage of small blood vessels in the lungs, hampers gas exchange, driving down oxygen levels, and can lead to death through oxygen desaturation. Other organs can also become seriously damaged, because DIC can block up blood vessels anywhere in the body. Larger blood clots can cause strokes, heart attacks, kidney failure and suchlike. Clots forming in veins, in the legs, can break off and travel into the lungs where they create pulmonary embolism. […] Essentially, people die as a result of blood clots.” [iii]
The Cytokine Storm
Kendrick attributes DIC to endothelial damage, which triggers a widespread inflammatory response that, in turn, “triggers the development of blood clots – not just in the lungs – but also everywhere else in the body. The endothelial damage is, in effect, the body attacking itself, through an immune response – the so-called ‘cytokine storm’. Some of the resulting clots that result are small, some big.” Kendrick concludes that impairment of blood circulation is what all of these symptoms have in common. “Add in the fact,” he writes, “that 40% of deaths from COVID-19 are related to cardiovascular complications, and the disease starts to look like a vascular infection instead of a purely respiratory one. In fact, COVID is both a respiratory and cardiovascular disease. However, I believe that its many manifestations, and the way that it kills people can be explained by the unifying observation that it damages endothelial cells.”
COVID causes vascular illness
Talking to Dana Smith of ELEMENTAL/Medium, Dr. Mandeep Mehra, medical director of the Brigham and Women’s Hospital Heart and Vascular Center in Boston (USA) and one of the members of the Rutschitzka team, explained that when we put all of the currently available data together, it turns out that this virus affects the blood vessels. “The concept that’s emerging,” said Mehra, “is that this is not a respiratory illness alone, this is a respiratory illness to start with, but it is actually a vascular illness that kills people through its involvement of the vasculature.” Just to be clear, Mehra emphasizes: “What we’re saying is that maybe the best antiviral therapy is not actually an antiviral therapy. The best therapy might actually be a drug that stabilizes the vascular endothelial. We’re building a drastically different concept.” [iv]
What all this boils down to is that COVID-19 seems to disturb microvascular homeostasis. In a previous article, I explained that homeostasis can be compaired with a complex cruise control system that supervises the dynamic and constantly active interplay of numerous means and modes of action that work towards the establishment and maintenance of the optimum structure and function of the many systems that support the survival and health of our bodies. The endothelium forms an integral and essential part of the microvasculature, which connects the arteries filled with blood coming from the heart and the veins filled with blood streaming back to the heart. It is here that the endothelium facilitates the exchange between blood and lymph and tissues. Microvascular homeostasis controls adequate microvascular blood flow, blood pressure, blood distribution and perfusion. Briefly put, COVID-19 challenges microvascular homeostasis.
Masquelier’s OPCs facilitate microvascular homeostasis
Numerous pertinent human, animal and cell studies strongly support the claim that Masquelier’s OPCs can help maintain healthy microvascular structures and functions by positively acting on the microvasculature’s homeostasis. OPCs support the constituent network of the microvascular wall by protecting collagen and elastin fibers against degradation as well as enhancing synthesis of collagen and by combating inflammation and oxidative stress. Depletion or impairment of the microvascular homeostatic capacity may eventually find its expression in the various phenomena of endothelial dysfunction.
Masquelier’s OPCs relevant for everyone
Masquelier’s OPCs has been shown to produce beneficial effects in populations suffering from various microvascular disorders by facilitating the dynamic mechanisms of remodelling and self-repair that restore the microvascular homeostatic capacity and thereby balancing the “internal milieu” of the microvasculature. The effects of OPCs are robustly present in healthy and diseased populations, meaning that supplementation of the daily diet with Masquelier’s OPCs is relevant for healthy people as well as people suffering from vascular problems.
[i] Endothelial cell infection and endotheliitis in COVID-19; Zsuzsanna Varga, Andreas J Flammer, Peter Steiger, Martina Haberecker, Rea Andermatt, Annelies S Zinkernagel, Mandeep R Mehra, Reto A Schuepbach, Frank Ruschitzka, Holger Moch; The Lancet, May 2, 2020.
[ii] Electron microscopy of SARS-CoV-2: a challenging task; Zsuzsanna Varga, Andreas J Flammer, Peter Steiger, Martina Haberecker, Rea Andermatt, Annelies Zinkernagel, Mandeep R Mehra, Felix Scholkmann, Reto Schüpbach, Frank Ruschitzka, Holger Moch; The Lancet, May 19, 2020
[iii] How does Covid kill people?; Dr. Malcolm Kendrick; 2 June 2020;
[iv] Coronavirus May Be a Blood Vessel Disease, Which Explains Everything; Dana G. Smith; Elemental Medium; 29 May 2020;