This is taken from a talk by Dr. Mobeen Syed, on the drbeen website. I just subscribed to this.

Mobeen Syed M.D, MS Graduated from King Edward Medical University. Entrepreneur, Medical Educator, CEO and founder of Drbeen corp.

Covid-19 causes long term blood cell changes Dr. Mobeen talks about a paper giving evidence that Covid-19 deforms or misshapes cells and that stem cells in bone marrow produce deformed or misshaped cells. This is the paper:

Microcellular congestion can lead to severe organ damage, possibly caused by deformed blood cells. Some patients recover quickly after hospitalization but others take several months. Blood cell deformation is hypothesized to contribute to long haul covid as well.

Blood cell congestion in the brain can cause neurological symptoms: headaches, depression, tinnitus, brain fog, other problems.
Other tissues can also get congested and have problems: heart, lungs, kidneys, digestive system.
reduction in cellular function
To fight infection, we need to be in fit shape, and our cells do too.

Phenotype is the shape and appearance of something: the phenotype of blood cells change with Covid-19 infection.

The paper compares covid postitive to covid recovering to normal volunteers.

There are currently multiple hypotheses about long haul Covid-19.
1. monocytes carrying S1 part of spike protein
2. mast cell activation syndrome
3. macrophage activation syndrome -- monocytes holding S1 and releasing cytokines
4. stem cells could also be damaged under bombardment of cytokines, incorrect cell formations
5. All of the above.

This paper can now prove that there are congestion issues from the cell misshapes. Blood vessels progressively get smaller and smaller. Capillaries are where oxygen and nutrition and waste products are exchanged, carbon dioxide is removed. Blood cells are larger than capillaries, so when cell goes through slowly because it has to squeeze and change shape, it helps get oxygen out and nutrition into the tissues and removed waste products and carbon dioxide. Blood cell shape is critical.

They have a new test: Real-time deformability cytometry.
Sheath inlet forms a stream, a microscopic river, that flows past the Sample inlet. The Sample inlet has a 1:20 dilution of the blood and is further diluted when it joins river. The dilution allows them to look at ONE Cell at a time. The flow goes to Image analysis diluted to single cells. A picture is take, like pictures on a roller coaster, a photograph as an individual cell passes through. The picture is taken through a microscope with a camera, so that they can compare Covid-19 affected cells with normal cell structure. The flow then goes to the outlet.

Covid-19 affected blood cells are bigger and mushier and misshapen. In people recovering, they are in between, not normal but not as mushy and deformed.

Normal erythrocyte: red cell 6-8 micrometer.
Capillaries 5-10 um
White blood cells:
Lymphocytes 6-9 um
Neutrophils 9-15 um
Monocytes 15-18 um

Red cells, erythrocytes, are bigger and mushier than the normal healthy red cells. Recovering patients have cells that are in between. Dr. Syed said that it's like us hiding from the pandemic: the cell gains weight and gets mushy. Same with the white blood cells. They looked at multiple individual cells from:

17 covid patients
14 recovering
24 normals

Red blood cells became less flexible and deformable. Red cells need be flexible to go through the capillaries AND the spleen's job is to note abnormal cells and kill them. The spleen thinks the deformed red cells are old worn out red blood cells.
Lymphocytes: B cells, T cells, more mushy and less stiff. They can't bind to the cells as well when mushy, jelly like, deformed.
Neutrophils: larger, deformed and more of them. Active, large, deformable and they do not know why.
Monocytes: larger. Much larger, mushy, don't work right.

The authors focused on the red blood cells. If red bloods cells are not functional then they don't deliver oxygen as well. Red cells live an average of 120 days. Stem cells replace them, but if the bone marrow is messed up too, they may not make normal red blood cells.

Reactive oxygen species form because infection is present. Covid-19 Delta causes intense infection and damage, more reactive oxygen species are produced and they damage the cell membranes. The cell loses flexibility, develops holes. Within the cells, the basic skeleton of the cell is not right. The cytoskeleton gets damaged and the cell loses shape*. It can't carry oxygen as well and also can't get through the capillaries as well. If too many rbcs get stuck in the spleen, the spleen can get congested. It may kill the red cells and abdominal trauma can lead to death by splenic rupture.

In sickle cell anemia, the cells sickle in a crisis and won't go through the capillaries, causing joint and organ pain and damage. So what about sickle cell patients? Are they sicker with Covid-19? Also sickle cells don't live as long. So they might get sicker but might also recover faster.

Outcome of the rbc cell deformity:
decreased 02 content

Which leads to:
visual problems
other neurological problems
tachycardia -- any stress exercise will put a burden on the heart and cause tachycardia

Impaired immune function leads to
active immune cells releasing more cytokines
causes shape issues by changing stem cells which then make impaired immune cells
leads back to impaired immune function and you get a dangerous feedback loop aka cytokine storm

"Hyperinflammation and cytokine storm syndrome are reported in Covid-19 cases with high levels of macrophage inflammatory 1-alpha, granulocyte colony stimulating factor (G-CSF), Interleukins IL-2 and IL-7, interferon gamma inducible protein 10, moncyte chemoattractant protein 1 and tumor necrosis factor alpha**."

"The persistent alteration of erythrocytes and neutrophils could be connected with long term symptoms of the recovered patients, of which 70% described headaches or neurological symptoms, 54% had concentration disorders and 62% circulatory problems like cold sweat and tachycardia. We hypothesize that the persisting changes of blood cell physical phenotypes could contribute to the long term impairment of circulation and oxygen delivery linked with Covid-19."

Dr. Syed lists two examples where treatment has improved oxygenation: a colleague with brain fog, being treated for another disease. He started a long covid protocol. She has started hiking and is improving.

Another patient has long covid and went for hyperbaric oxygen treatment with significant improvement.

In both of these examples, improvement of oxygenation helped reduce symptoms.

The conclusion is that patients with long haul possibly may have problems with any of the different blood cells: erythrocytes, macrophages, mast cells, lymphocytes or neutrophils.

I thought of it as "lung swelling" back in 2003 when I was out for two months after influenza pneumonia. Resting heart rate up from normal 70 to 100 and walking across a room, heart rate 135. I held my oxygen saturation up at 98% but the heart racing was exhausting. I was 42. It appears that it could be cell deformation rather than lung swelling, but the concept that one has less oxygen available would fit with this.

*This brings up tubulin for me, since it is an important cell structural component.
**Before medical school in the late 1980s, I worked at the National Institute of Health in the Surgery Branch of the National Cancer Institute. We were working with Interleukin 2 and Tumor Necrosis Factor. I was a lab tech. I left to start medical school in 1989.

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