Can erythrocytes behavior in microcirculation help the understanding the physiopathology and improve prevention and treatment for covid-19?

Abstract

Low plasma estrogens, vitamin D deficiency, obesity, diabetes, cardiovascular diseases, thromboembolism, and impaired microcirculation are linked to the severity of covid-19. Studies have suggested that these comorbidities also are related to erythrocyte factors linked to increased blood viscosity in microcirculation such as erythrocyte aggregation and erythrocyte deformability. Increased blood viscosity in microcirculation can lead to a decrease in oxygenation and nutrition of tissues. Therefore erythrocyte aggregation and erythrocyte deformability may be involved in covid-19 severity, leading to tissue hypoxia and a decrease of drug concentration in affected organs. If this relationship is demonstrated, erythrocytes factors can be used to monitor treatments for improve microcirculatory fluidity that may decrease covid-19 severity. Lifestyle improvement and treatments such as vitamin D and estrogens supplementation are some possible approaches to improve microcirculation and covid-19 prevention and treatment.

COVID-19 and thrombosis: The role of hemodynamics

“…Hyperviscosity disrupts the Fåhræus-Lindqvist effect and could result in the formation of in-situ capillary thrombosis. Hyperviscosity in microcirculation can also impair the delivery of oxygen and nutrients to the tissues [38] . In a study of 15 severe COVID-19 patients, it is observed that all patients had high values for plasma viscosity ranging from 1.9–4.2 cP (normal range 1.4–1.8 cP) [39] .…”

Metabolic Influences Modulating Erythrocyte Deformability and Eryptosis

“…The recent COVID-19 pandemic has generated a host of studies in all areas of biomedical research [235], and, unsurprisingly, disturbances in microcirculation [236] and the rheologic properties of blood [237] have been described. It is clear that endotheliopathies are important clinical features of acute COVID-19 [238,239].…”

Acute triiodothyronine treatment and red blood cell sedimentation rate (ESR) in critically ill COVID-19 patients: A novel association?

“…In addition, it has been associated with inflammatory and vascular endothelial function indices [6]. In the context of COVID-19, changes in erythrocyte function and microcirculation have been considered as an important part of the pathophysiology of the disease and need to be deeply investigated in order new effective treatments to emerge [7][8][9]. Along this line, red blood cell rheological properties are found to be impaired in COVID-19 [10,11].…”