COVID-19: Scientific insights on causes of mortality and morbidity by C2VN experts

CP COVID19 C2VN causes mortalité

While the spread of the CORONAVIRUS COVID-19 virus seems to be easing today in France, the pandemic has caused more than 300,000 deaths worldwide in just a few months since the beginning of 2020. This virus is not yet fully known but the causes of mortality and morbidity are multiple, here explained in mirror image by various researchers from the Cardiovascular and Nutrition Research Center (C2VN) whose expertise covers the entire spectrum of COVID-19 disease.

COVID-19 and lung: A peculiar respiratory infection.

COVID 19 infection is an acute respiratory illness. It affects every cell in the lung. In the vast majority of cases, it is not accompanied by major respiratory problems. However, in people with co-morbidities, it leads to respiratory distress secondary to a dysproportionate inflammatory reaction of the host. Careful monitoring of possible respiratory sequelae is important.
Contact: Pascal Chanez (C2VN, APHM).

COVID-19 is also a disease of the blood vessels...

All the arguments are present to say that COVID 19, which manifests itself in its serious forms by respiratory complications, is also a disease of the cells that cover the inner face of the vessels, called "endothelium": the presence of the virus receptor (ACE2) on these endothelial cells, cardiovascular complications (pulmonary embolisms, strokes...), and generalized inflammation of the microcirculation. This opens up new therapeutic avenues for the prevention and management of cardiovascular and inflammatory complications of COVID-19.
Contact: Françoise Dignat George (C2VN, APHM).

Lung Embolism at the heart of VIDOC complications-19

Pulmonary embolism is the 3rd cause of cardiovascular mortality in France (10,000 to 20,000 deaths per year). Its incidence is increasing significantly in COVID-19 patients. This increase is due to a coagulopathy specific to this infection called 'pulmonary intravascular coagulopathy' leading to the formation of blood clots locally in the pulmonary circulation. Heparin, an anticoagulant used to prevent the formation of clots, may reduce mortality in severe forms of COVID-19. Contact: Marie-Christine Alessi, Pierre-Emmanuel Morange (C2VN, APHM). Kidney in COVID-19: a guilty victim. The SARS-COV-2 has the ACE2 receptor, an important enzyme in the control of blood pressure. ACE2 is widely expressed in renal tissue, which explains the high frequency of acute renal failure, up to 80% of cases in resuscitation, in COVID-19. Chronic renal disease affects 3 million French people, often elderly, and it is now certain that it is a risk factor for severe forms of COVID-19. Endothelial activation probably plays an important role in the sensitivity of these patients to this virus. Thus the kidney is a victim but also responsible for more serious forms. Contact: Stephane Burtey (C2VN , APHM).

Diabetes and obesity: Major factors in severe forms of Covid-19

The ENDO pole of AP-HM and the C2VN participated in a French multicentric study supported by the French Diabetes Society "CORONADO" which evaluated the phenotypic characteristics of diabetic patients with Covid-19 and the factors associated with resuscitation or death. A first article published in Diabetologia on 186 patients showed the importance of admission blood glucose and Body Mass Index in the severity of symptomatology. In addition, the immunity study of diabetic patients with Covid-19 detected an altered monocytic response with a decrease in the number of circulating cytotoxic lymphocytes that may contribute to the severity of symptoms in this fragile population.
Contact: Anne Dutour-Meyer (C2VN , APHM).

The Cardiovascular and Nutrition Research Centre (C2VN - UMR AMU- Inserm - INRAE - AP-HM)

The C2VN is a research centre of Aix Marseille University located on the Timone campus, bringing together Inserm, Inrae and university researchers and university hospitals. This unit, made up of six teams, brings together cutting-edge talents in vascular biology, thrombosis, inflammation and nutrition. It is particularly interested in chronic metabolic and inflammatory pathologies (obesity, diabetes, kidney failure, respiratory failure) and vascular (thrombosis and pulmonary embolism). All of this expertise has led several members of the centre to invest in understanding the mechanisms behind severe forms of COVID-19 by highlighting the roles of endothelial dysfunction, thrombosis and various co-morbidities. Special attention must be paid to fragile populations affected by COVID , such as diabetics, people with respiratory insufficiency or kidney failure, who identify populations at risk. This also opens up new avenues for the management of COVID 19 complications, at the crossroads of pulmonary, vascular, thrombotic and inflammatory responses, which are themselves at the heart of the research work of the C2VN teams.
Director: Marie Christine Alessi, (0614533578)
Deputy Director: Françoise Dignat-George (0620615478 )

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