Overload of Inflammatory Molecules “Trapped” in Micro Blood Clots May Cause Long COVID Symptoms

Blood Clot Rendering

New research suggests that trapped inflammatory molecules in microscopic blood clots (micro clots) might cause lingering symptoms in Long COVID patients.

First evidence of inflammatory micro clots in blood of individuals suffering from Long COVID: This may be the cause of some of the lingering symptoms experienced by individuals with Long COVID.

New research indicates that an overload of various inflammatory molecules, literally “trapped” inside insoluble microscopic blood clots (micro clots), might be the cause of some of the lingering symptoms experienced by individuals with Long COVID.

This unexpected finding was made by Prof Resia Pretorius, a researcher in the Department of Physiological Science at Stellenbosch University (SU), when she started looking at micro clots and their molecular content in blood samples from individuals with Long COVID. The findings have since been peer-reviewed and published in the journal Cardiovascular Diabetology in August 2021.

“We found high levels of various inflammatory molecules trapped in micro clots present in the blood of individuals with Long COVID. Some of the trapped molecules contain clotting proteins such as fibrinogen, as well as alpha(2)-antiplasmin,” Prof Pretorius explains.

Alpha(2)-antiplasmin is a molecule that prevents the breakdown of blood clots, while fibrinogen is the main clotting protein. Under normal conditions the body’s plasmin-antiplasmin system maintains a fine balance between blood clotting (the process by which blood thickens and coagulates to prevent blood loss after an injury) and fibrinolysis (the process of breaking down the fibrin in the coagulated blood to prevent blood clots from forming).

With high levels of alpha(2)-antiplasmin in the blood of COVID-19 patients and individuals suffering from Long COVID, the body’s ability to break down the clots is significantly inhibited.

Micro Blood Clots Long-COVID

Fluorescent image of healthy blood plasma (left) compared to the micro clots in the plasma from an individual with Long-COVID on the right. Credit: Resia Pretorius

The insolubility of the micro clots became apparent when Dr Maré Vlok, a senior analyst in the Mass Spectrometry Unit at SU’s Central Analytical Facilities, noted that the blood plasma samples from individuals with acute COVID and Long COVID continued to deposit insoluble pellets at the bottom of the tubes after dilution (a process called trypsinization).

He alerted Prof Pretorius to this observation and she investigated it further. They are now the first research group to have reported on finding micro clots in the blood samples from individuals with Long COVID, using fluorescence microscopy and proteomics analysis, thereby solving yet another puzzle associated with the disease.

Of particular interest is the simultaneous presence of persistent anomalous micro clots and a pathological fibrinolytic system,” they write in the research paper. This implies that the plasmin and antiplasmin balance may be central to pathologies in Long COVID, and provides further evidence that COVID-19, and now Long COVID, have significant cardiovascular and clotting pathologies.

Further research is recommended into a regime of therapies to support clotting and fibrinolytic system function in individuals with lingering Long COVID symptoms.

Working with vascular internist Dr. Jaco Laubscher from Mediclinic Stellenbosch (a co-author on the article), they now plan to perform the same analysis on a larger sample of patients. To date they have collected blood from one hundred Long COVID individuals who participated in the Long COVID registry which launched in May 2021, as well as from 30 healthy individuals. The research is funded by the Long COVID Research Charitable Trust, a trust established with an initial donation made by Mr. Koos Pretorius from ENSafrica. It is intended that this trust will be used as a vehicle to raise further funds for research into the causes and effective treatment of people suffering from Long COVID.

Reference: “Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin” by Etheresia Pretorius, Mare Vlok, Chantelle Venter, Johannes A. Bezuidenhout, Gert Jacobus Laubscher, Janami Steenkamp and Douglas B. Kell, 23 August 2021, Cardiovascular Diabetology.
DOI: 10.1186/s12933-021-01359-7

1 Comment on "Overload of Inflammatory Molecules “Trapped” in Micro Blood Clots May Cause Long COVID Symptoms"

  1. Sekar Vedaraman | October 5, 2021 at 11:28 am | Reply

    Very Interesting Research Findings.

    “How do we restore the balance between the clotting of Blood required to protect the Human Ecosystem, when you have a trojan horse creating micro Blood Clots”?

    Are there Nano Versions of Blood Thinners like anti-platelet drugs to slow down plateets clumping together and anti-coagulants (to slow down blood clotting), which can address the Problem and address Long Covid root cause/Symptoms?

    The Micro Blood Clots require a effective Nano Blood Thinner, so that the balance can be restored in the circulatory System.

    Patients who have recovered from the Covid-19 infection have impaired Circulatory Systems, and Long Covid needs to be fixed, using newer effective drugs, which can prevent Internal blood clots at the micro level and also prevent these micro blood clots from aggregating and stopping normal blood flow through the extremely thin capillaries in the Human Ecosystem.

    Clots in your arteris , veins and heart can cause heart attacks, strokes and blockages.

    Currently the people who take Blood Thinners are those afflicted with :

    (1) atrial fibliration (those with abnormal heart rhythm) treated permanently with ablation by Heart Specialists and if not addressable by ablation, treated with blood thinners.
    (2) People who have had a heart valve replacement
    (3) People with certain Heart and Blood Vessal Diseaeses
    (4) People who have undergone surgery and the risk of blood clots increases
    (5) People with congenitall heart defects.

    There are two main types of blood thinners.
    (1) Anti – Coagulatants like warfarin ( also called Coumadin) and heparin which slows down the bodies processes for making Blood Clots.
    (2) Anti- PLatlet drugs like asprin which prevent the Platelets from clumping together.

    Blood Thinners need to be tken only under a Qualiffied Heart Surgeon or Heart Specialists Care, AND Doctors advise, as they interact with certain medicines, foods , vitamins and ALCOHOL.

    If Long Covid shows that there is a insoluble internal blood clot formation as a result of Covid-19 Infection , we need to figure out what drugs can ensure that the said Insoluble molecule is dissolved with micro and nano level blood thinners to address Long Covid. This will ensure that Blood flow in the circullatory system is restored to normal and the risks of
    heart attacks and other heart ailments are minimised and heart functioning return to normal.

    Views expressed are personal not binding on anyone

    Long Covid needs to be addressed by Medical Professionals working with Scientists. The potential Market Size Globally is all the people across the globe who have been infected by Covid -19 and have apparaently recovered.

    In my personal opinion , Long Covid is likely to be the most debilitating of illnesses in the next two decades.

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