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Impaired Tissue Perfusion – A Pathology Common to Hypertension, Obesity, and Diabetes Mellitus

The microcirculation is generally taken to include the smallest arteries, the arterioles, capillaries, and venules.^1,2 Exchange of gases, nutrients, and metabolites between the blood and tissues occurs almost exclusively in the microcirculation, and adequate perfusion via the microcirculatory network is essential for the integrity of tissue and organ function. Our aim in the present article is to bring together recent clinical and experimental research indicating that inadequate perfusion may underlie much of the tissue and organ dysfunction associated with chronic conditions including hypertension, obesity, and diabetes mellitus.

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Impaired Tissue Perfusion, A Pathology Common to Hypertension, Obesity, and Diabetes Mellitus

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Experts say D’OXYVA^® can help patients find relief. Overwhelming medical data shows people with preexisting conditions, including diabetes may experience serious complications with COVID-19.

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More physical issues the Centers for Disease Control and Prevention (CDC) warns about include inflammation of the heart muscle, acute kidney injury, and hair loss. But a growing number of COVID patients seem to also be developing diabetes, which could need managing for the rest of their lives. Diabetes appears to be both a risk factor for COVID and a long-term effect of the illness.

Mihail Zilbermint, MD, who cares for patients with metabolic disorders at Suburban Hospital in Bethesda, Maryland, recently told The Washington Post that his caseload has nearly doubled with patients recovering from COVID-19. “Before, we used to manage maybe 18 patients per day,” he said. Now, his team cares for as many as 30 daily.

Zilbermint described how many of the patients had no prior history of diabetes. Some developed elevated blood sugar levels while they were in hospital, which returned to normal by the time they were discharged. However, others were diagnosed with full-blown diabetes by the time they went home and some developed the disease in the weeks that followed. “We’ve definitely seen an uptick in patients who are newly diagnosed,” said the doctor.

Covid-19 May Be a Blood Vessel Disease, Which Explains Everything

Many of the infection’s bizarre symptoms have one thing in common

In April of 2020, blood clots emerged as one of the many mysterious symptoms attributed to Covid-19, a disease that had initially been thought to largely affect the lungs in the form of pneumonia. Quickly after came reports of young people dying due to coronavirus-related strokes. Next it was Covid toes — painful red or purple digits.

What do all of these symptoms have in common? An impairment in blood circulation. Add in the fact 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.

NIH Study Uncovers Blood Vessel Damage and Inflammation in COVID-19 Patients’ Brains But No Infection

Results from a study of 19 deceased patients suggests brain damage is a byproduct of a patient’s illness

In an in-depth study of how COVID-19 affects a patient’s brain, National Institutes of Health researchers consistently spotted hallmarks of damage caused by thinning and leaky brain blood vessels in tissue samples from patients who died shortly after contracting the disease. In addition, they saw no signs of SARS-CoV-2 in the tissue samples, suggesting the damage was not caused by a direct viral attack on the brain. The results were published as a correspondence in the New England Journal of Medicine.

“We found that the brains of patients who contract infection from SARS-CoV-2 may be susceptible to microvascular blood vessel damage. Our results suggest that this may be caused by the body’s inflammatory response to the virus,” said Avindra Nath, M.D., clinical director at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and the senior author of the study. “We hope these results will help doctors understand the full spectrum of problems patients may suffer so that we can come up with better treatments.”

Reducing the Impact of Comorbidities with COVID-19 Infection

Significant improvements in systemic circulation, especially in the critical microcirculation and microvessels with oxygen-balanced blood flow

In the middle of a global pandemic, like the one we’re living, it is highly relevant to be able to assess risk. This is not only important for seeing indications of infection susceptibility, but also to be better able to look for solutions to diminish the impact of risk factors in the infection rates and progression. We are not all equally vulnerable to the SARS-CoV-2, the virus responsible for the worldwide lock down that started late last year in China. Experience so far has shown that there is a series of factors that correlate with a worse prognosis, even leading to death.

According to the CDC (Centers for Disease Control and Prevention) and the NHS (National Health Systems) in the United Kingdom, the best known risk factors so far are:

⎯ A weak immune system (immunodeficiency), such as in those that have recently had a transplant, bone marrow recipients, cancer patients, those with poorly controlled HIV or AIDS, and those with prolonged use of corticosteroids or medications that lower immunity.

⎯ Old age. People over 65 years of age have been shown to suffer more and more often from coronavirus infection.

⎯ Chronic lung disease, such as chronic obstructive pulmonary disease (COPD) or asthma

⎯ Diabetes

⎯ Cardiovascular disease and/or serious heart conditions

⎯ Severe obesity (body mass index [BMI] of 40 or higher)

⎯ Chronic kidney disease undergoing dialysis

⎯ Liver disease

⎯ Pregnancy

⎯ Smoking

Most of these factors are quite common in the first world. In the United States, for instance, the prevalence of diabetes in the adult population is 10.1%. There is a similar prevalence of cardiovascular disease at 10.6%. Given these statistics, the great extent of at-risk populations in the United States becomes clear. Data from China also confirms the impact of comorbidities, such as respiratory disease, cardiovascular problems, and diabetes, on disease progression and the worsening of health outcomes in these patients.

Among these risk factors, cardiovascular disease and diabetes stands as two of the most dangerous ones. Reports from Chinese authorities and from top American institutions, such as the Harvard Medical School, show that underlying cardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized with COVID-19. It also seems that underlying cardiovascular disease also increases the probability of suffering from COVID-19 related cardiac problems, such as myocardial injury or arrhythmia. The full extent of the interplay between cardiovascular disease and COVID-19 is not yet known. However, it is clear that any means capable of improving cardiovascular health, both before and after infection, will go a long way in diminishing the deleterious effects of a coronavirus infection.

A recently discovered effect of COVID-19 infection is the development of potentially deadly blood clots. For instance, a Dutch team reported that out of 184 severe COVID-19 patients in intensive health units, about 31% had some sort of thrombotic episode. This is a remarkable proportion, which adds weight to the notion that improving blood perfusion and tissue oxygenation is of the utmost importance in diminishing the virus’ lethality.

So far, acute treatment of serious cases of COVID-19 has involved the use of blood thinners (anticoagulants), such as heparin, and oxygenation. However, there is a new treatment option available: D’OXYVA^®.

D’OXYVA^® is a groundbreaking completely painless and noninvasive transdermal delivery system shown to produce higher oxygen unloading by hemoglobin, thereby increasing oxygen-rich blood flow in the local microcirculatory system, which in turn leads to better blood perfusion and tissue oxygenation. Several clinical studies have demonstrated its effectiveness while reporting on zero side effects. Even where standard treatments have failed, D’OXYVA^® achieves an improvement on health indicators like blood pressure, tissue oxygenation and wound healing. An additional advantage of is how easy it is to use it. There is no need for a clinical setting or additional expertise to use it. It can be applied even while sitting on the sofa watching your favorite show.

The evidence supporting the use of D’OXYVA^® is manifold:

⎯ Three dozen human studies in the last eight years have reported zero adverse events associated with D’OXYVA^® use. These studies run in collaboration with prestigious universities and hospitals around the world (including Penn State and Airlangga University) and are to be expanded in a recently IRB-approved pivotal trial.

⎯ D’OXYVA^® pharmaceutical-grade carbon dioxide is FDA-approved and analogous to that available in hospitals and clinics.

⎯ Transdermal carbon dioxide has shown positive results in wound care in clinical studies. Healing, wound closure, and sepsis prevention and septic shock avoidance have been shown after D’OXYVA^® application, even when other treatment modalities have failed.

⎯ Clinical data has also shown a consistent, significant decrease in systolic and diastolic blood pressure for up to 240 minutes after a single treatment with D’OXYVA^®.

⎯ The perfusion index (PI) is the ratio of pulsating blood flow to static blood in peripheral tissue and acts as an indirect measure of blood peripheral perfusion, that is, how much blood reaches a particular tissue. This parameter is also greatly improved after D’OXYVA^® application, as demonstrated in several clinical trials.

⎯ D’OXYVA^® has also been shown to increase O₂ saturation in patients treated with transdermal CO₂ in comparison to controls for up to 2 hours after application.

⎯ Transdermal CO₂ can successfully improve organ function (pancreas, liver, brain, and kidneys) and general health status in patients with hypertension.

In light of this evidence, it is clear that D’OXYVA^® is a strong treatment option not only for those people already infected by the SARS-CoV-2 virus, with and without concomitant health risks, but also to everyone who wants to improve their health status and, thereby, decrease the potential physiological impact of the coronavirus. Obviously, people with underlying diseases and those at higher risk for COVID-19 will benefit even more from better tissue oxygenation. Improved microcirculation leads to better tissue oxygenation and better heart function, as the heart does not need to exert extra force to bring the blood to all the organs of the body.

Circularity Healthcare, the proprietary of the D’OXYVA^® technology, is about to launch a significantly expanded multicenter pivotal human clinical trial to demonstrate that D’OXYVA^® is a strong ally in the treatment of coronavirus patients. Initial study sites include the University of Harvard, Yale University, the Massachusetts Institute of Technology, the University of Southern California, and the University of California at Los Angeles. As monitoring can be performed at home, patients do not need to be hospitalized and can join the trial even with mild symptoms, which allows for long-term monitoring (up to four months) and characterization of parameters at various stages after infection.

The primary endpoint of the study is full recovery. Improvement in other health parameters, such as white and red blood cell count, angiogenesis, blood pressure and blood sugar levels, perfusion rates, and tissue and cell regeneration will be monitored.

Results of this trial will add to the mounting evidence supporting D’OXYVA^® use as a coadjuvant in the treatment of COVID-19 patients, as it is clear that cardiovascular problems pose one of the biggest risks for coronavirus mortality, whereas proper tissue oxygenation via improved oxygen-rich blood flow counteracts these health risks, diminishing the effects of blood clotting and reducing the physical heart exertion needed to pump blood to organs like the brain, lungs, and others.

Reference(s)

COVID Could Give You This Lifelong Disease

https://elemental.medium.com/coronavirus-may-be-a-blood-vessel-disease-which-explains-everything-2c4032481ab2

https://www.nia.nih.gov/news/nih-study-uncovers-blood-vessel-damage-and-inflammation-covid-19-patients-brains-no-infection

https://www.ahajournals.org/doi/full/10.1161/circresaha.115.305364