Insights on COVID-19
This article will be covering insights on COVID-19, as well as looking into the coronavirus from within. With the understanding of the virus’s nature, habits, and life cycle. A lot of information currently available seems to be fragmented and many at times, resulting in panic rather than understanding. I wanted to pass on some of what I consider to be the most important insights on COVID-19. Hopefully, this information will not only help with any fear or confusion but will also help keep you and your loved ones safe and healthy.
It is important to understand that viruses classified as coronavirus have existed long before COVID-19 or SARS-CoV-2 and that COVID-19 is just one of many different types of coronaviruses. There are currently 7 types of human coronaviruses that were first identified in the mid-1960s:
- 229E (alpha coronavirus)
- NL63 (alpha coronavirus)
- OC43 (beta coronavirus)
- HKU1 (beta coronavirus)
- MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
- SARS-CoV (the beta coronavirus that causes the severe acute respiratory syndrome, or SARS)
- SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)
Insights on COVID-19 strains, infection & antibodies
SARS-CoV-2 causes COVID-19, however, the pathogenesis of the virus is different. This means that there are different mutations of the virus, and this leads to infections being different in different countries.
You can view a more detailed map of the development of the strains on NextStrain. This virus can create up to 270 different strains. It is important to understand which category a patient’s infection corresponds to, as this will determine how severe the infection may progress.
The strains which showed the most intensity in their development:
China > Europe > Eastern part of the American continent
The strains which showed the least intensity towards their development:
China > Asia
China > Western part of the American continent
The virus developing different strains is actually seen as a positive sign. This means that the virus is becoming less aggressive. For instance, in Korea, it was observed that their SARS-CoV-2 variants had deletions at the S1/S2 junction in their genome. This specific deletion meant that the virus will no longer be as aggressive as before.
COVID-19 stages of infection
The virus is present, yet a person may not be symptomatic but is infectious. Approximately 40% of people were infected by non-symptomatic, infectious people.
Some people become symptomatic; others can remain non-symptomatic. At this stage, the virus keeps developing. If a patient is symptomatic, symptoms can be:
Fever, cough, sore throat, hoarseness, severe headache, muscle pain, loss of smell, chest pain, loss of appetite, diarrhea, abdominal pain, fatigue, shortness of breath, rash on the skin, and confusion.
Cytokine storm and a disturbance with hypercoagulation.
It is important to understand that not only does COVID-19 develop different strains, but that 1 strain can affect every individual in one family differently. This also corresponds to people who may or may not have antibodies after COVID-19 infection. A study has shown that out of 171 symptomatic patients, only 11 showed antibodies post-infection. Those who have gained antibodies also showed a decrease in those antibodies in a short time (1 to 2 months), meaning they can once again be infected with COVID-19. In regards to antibodies, it is crucial to note that not only the presence of antibodies is important, but also the strength of those antibodies.
Factors for antibodies:
- It was observed that on average, the younger patients had a higher rate of no presence of antibodies, in comparison to the older patients who had a higher rate of antibodies post COVID-19 infection.
- Another observation made was regarding the strength of the immunity built. The higher rate of immunity was found in patients who had severe symptoms during infection, in comparison to those who showed lighter symptoms of COVID-19.
Symptoms of COVID-19
The information below is taken from an online video by Ancha Baranova, Ph.D. She is a professor and a specialist in the functional genomics of complex human diseases. During the COVID-19 pandemic, she has posted many YouTube videos, giving the public a deep understanding on a molecular level as to what really happens during infection and how and why the virus can progress.
It is also essential to know that coronaviruses, including the SARS-CoV-2 type, develops and flourishes in the intestine. This is because the intestine provides the virus with all the receptors it needs, and during the virus’s replication process, it also causes certain symptoms of discomfort.
For COVID-19, any intestinal discomfort must not be dismissed, as it may very well be the primary symptom of the virus contraction, and if ignored, can develop into a more serious state, such as that in the lungs.
Infants and young children tend to only have intestinal discomfort as a symptom of COVID-19, without it further developing into pneumonia.
Many consider an adult to be non-symptomatic if they do not have the commonly mentioned symptoms of tiredness, dry cough, or fever. Many ignore the symptoms of discomfort manifested due to the viral infection in the gut; such as overall pain, bloating, diarrhea, or constipation.
The intestine is the barrier organ
The intestine acts as a barrier organ and what happens within it, may not be happening across the other organs and tissues.
In our intestine, we have a protein called ACE-2, which also serves as a receptor to SARS-CoV-2 (perfect match like a lock and key). The presence of ACE-2 is high specifically in the small intestine, mainly because it is needed to be there.
ACE-2 is responsible for many functions. One of the vital functions is that without the presence of ACE-2, the body would not be able to absorb tryptophan (an amino acid which we get from food, that is needed in the biosynthesis of proteins). The protein which transfers tryptophan inside cells is dependent on the help which it receives from protein ACE-2. When tryptophan is found inside the cells, it is used for many important functions.
The primary vital function is the synthesis of proteins within a cell. Tryptophan is also a regulator synthesis of antimicrobial peptides that play a role in the defense mechanisms against harmful microbial organisms. These are especially important in the intestine as it is a rich habitat for microbes, of which the majority are good and which we need.
When the intestine has the presence of a bacteria which is not good, existing bacteria switch to defense mode and these antimicrobial peptides are released to help fight off the harmful microbes. When there is a lack of antimicrobial peptides, the harmful bacteria not only remain but begin to multiple and slowly change the balance of the habitat towards their liking. This state is also referred to as small intestinal bacterial overgrowth (SIBO).
- The information above is just a partial piece of the picture of the importance of ACE-2. However, also highlights how the use of ACE-2 receptor blockers as a treatment against COVID-19, will cause severe damage across the entire system.
A group of proteins that are released by host cells and signal in response to the presence of viruses. These are vital when our body is attacked by certain viruses. Constant and high levels of interferon throughout a long period of time will cause you to feel tired and your entire body will be wearing itself out. This is why interferon is only produced in specific circumstances, by ‘special order’ so-to-speak.
In the intestine, however, the situation with interferon is quite the opposite. Interferons are always present in the intestine. It is unclear what exactly they are there for except that it would be quite impossible to have a healthy gut without them.
LPS is another example of the opposite situation of the ecosystem of the intestine in comparison to other organs and tissues. LPS are molecules of lipids and polysaccharides which are found in the outer membrane of gram-negative bacteria.
If LPS enters our bloodstream, it will cause inflammation. Therefore, the level of lipopolysaccharides in the body must remain low. In the intestine, however, it is the opposite with levels of LPS needing to be high.
This is why the intestine remains are a barrier organ. It creates and monitors the balance, so that there will not be any interference between the balanced levels that should be within other organs and tissues, and those levels within the intestine itself.
Our bodies & SARS-CoV-2
When SARS-CoV-2 enters our system, it feels very comfortable in taking over the barrier organ, our intestine. There, it easily finds tryptophan and with the help of perfectly matching like a key to lock with the ACE-2 receptor, enters our cells and begins multiplying. This is when our entire balance is placed into disharmony and our gut microflora begins to suffer as much as our intestinal cells.
At this stage, the intestine will try to go on defense, by producing even more interferons. The main problem is that the nature of the COVID-19 is that its biology does not give a high enough reaction to the production of a high enough dose of interferons. So as much as the intestinal cells try to produce more and more interferon, the levels are still not enough against SARS-CoV-2.
Following, a signal will be given to increase the production of ACE-2. With many other viral infections, both of high levels of interferon and the production of ACE-2 would be sufficient to fight off the infection. In the situation of COVID-19, these mechanisms do not affect the virus. This is why the virus can keep multiplying in the intestine for a fairly long period, as there are no internal mechanisms to slow it down.
Due to the lengthy amount of time SARS-CoV-2 is present and multiplying in the intestine, this results in an inflammation of the intestine. The gut doesn’t signal regarding the disbalance happening within. Most signaling is similar to intestinal discomfort. This is why it is very important to be aware of any changes that have a direct relation to your intestine.
Insights on COVID-19 Symptoms & Damage
Gastrointestinal tract not to be dismissed
With the severity of the inflammation of the intestine, the cells in the wall of the intestine begin to grow apart. This results in gaps between the cells and causes leaks of the gut. This leak means that everything that is found inside the intestine, is now being absorbed by the body. From all the substances that are now being absorbed by the body, the worst one is the lipopolysaccharides (LPS). They are relatively large, however, when there is a leak between the cells of the intestine, they can make their way through and get absorbed by the lymph nodes or by the blood.
LPS in the blood will result in the blood cells noticing the LPS, realizing that it is not meant to be here and coming to the conclusion that a bacterial infection is present somewhere. LPS are remains of a bacterial cell membrane, not viral and cells react to remains as they would to an entire bacterial cell. As a reaction, the cells will draw the conclusion that the system is suffering from sepsis (infection of the blood).
Infection of the blood causes the immune system to go completely off the rails. The immune system will ring all the possible bells and signals. The activation of the complement system and macrophages with various cytokines; which create the cytokine storm. Cytokines such as; tumor factor necrosis alpha, interleukin-6 (released in the situation of inflammation and makes you feel extremely tired), and many other agents. This results in a pseudo-sepsis situation. This means that there are no harmful bacteria present, however, the immune system that would react to bacteria, is full-on.
The activation of the complement system creates pores in a bacterial cell membrane, ultimately causing damage. Since in this case there are is no bacteria, the complement system can cause no damage to our cells, however can cause damage to the walls of our blood vessels. Such damage will result in interrupting blood flow and swelling. In the presence of pneumonia (bacterial or viral) in the lungs, additional damage to blood vessels will worsen the overall condition.
Hypercoagulation a symptom of COVID-19
Two processes were found; damage to coagulation resulting in hypercoagulation in vessels (a condition which causes your blood to clot easier than normal) followed by micro thrombocytes as a result of damage to the vessels. Abnormal coagulation is one of the COVID-19 symptoms.
A blood clot in the coronary blood vessels can result in myocardial infarction (heart attack). A blood clot in a blood vessel in the brain would result in a cerebral insult (stroke). If several blood clots are found throughout the bloodstream (disseminated intravascular coagulation), this can result in systemic vasculitis. Blockages of small blood vessels throughout the body and further causing excessive bleeding.
In patients with no symptoms or very mild symptoms, hypercoagulation can be the only proper symptom of COVID-19. It can and has presented itself as a large-vessel stroke in patients under 50.
It is highly advised that anyone that may experience a severe and abnormal headache, especially in the middle of the night, will seek medical attention as soon as possible.
Organ damage by COVID-19
Insights on COVID-19 organ damage is essential for patients who recovered from COVID-19 to be able to go through a proper rehabilitation post-infection.
Lungs with megakaryocytes
Megakaryocytes are large bone marrow cells that produce thrombocytes. Thrombocytes are essential for blood clotting, however, can also produce thrombosis. It is unnormal for megakaryocytes to be found in the lungs.
Brain hypoxia is the lowered oxygen levels delivered to the brain. The prevention of hypoxia is by maintaining the same level of oxygen to the tissues. Oxygen masks, oxygen sprays, fresh air, and even cold air-conditioned air (clean and circulated cool air as it carries more oxygen particles).
Small vessels blocked resulting in blockage of oxygen and damage, similar to microscopic heart attacks. Although individually not threatening, however, if the entire cardiac muscle is filled with many such damaged vessels, it results in the muscular damage of the entire organ. The visible damage is that of the enlargement of the heart.
High levels of protein in urine and abnormal blood work were seen from patients. In some cases, patients had to go on dialysis. SARS-CoV-2 can target kidney cells as the cells have receptors the virus can attach to. Blood clots in blood vessels can cause impairment to kidney function as well as the lack of oxygen causing the kidneys to malfunction. In severe cases with the cytokine storm present, healthy kidney tissues can be destroyed. Kidney damaged with COVID-19 patients was seen regardless of whether the patients had pre-existing conditions such as high blood pressure and diabetes, or had no pre-existing conditions or kidney injury.
Increased levels of liver enzymes; alanine aminotransferase (ALT) and aspartate aminotransferase (AST), an indication of at least temporary damage. Liver damage was found more common amongst patients with severe cases of COVID-19 and those with pre-existing liver injury.
It is inevitable that we will all eventually have to face COVID-19 one on one. In time, we will eventually learn how to live with SARS-CoV-2, as we did with many other infections. However, from all the insights on COVID-19, the most important thing to keep in mind is that while we wait for the time where we will coexist with SARS-CoV-2, it is essential to try and extend the period of not getting infected for as long as possible. One of the advised precautious and preparations is that of a balanced and healthy gut. The longer one maintains precautions, preventative measures as well as preparing their body, the bigger the chance of them having the least damage to their system when eventually they face the infection.