The SARS-CoV-2 virus overactivates and disrupts the renin-angiotensin system (RAS). We now have a better understanding of why some patients develop disabling diseases. Jean-Marc Sabatier explains.
The SARS-CoV-2 virus causes hyperactivation (and disruption) of the renin-angiotensin system or RAS (also known as the angiotensin-aldosterone system or AAS), a physiological system critical to human function. RAS is responsible for renal, pulmonary, and cardiovascular autonomic (automatic) functions. It also regulates innate immunity and various microbiota. RAS is ubiquitous in the body (present in cells of various tissues and organs). Dysfunctional RAS (because it is overactivated) is directly implicated in Covid-19 pathology via exacerbated activity of its ‘harmful’ receptor, AT1R. Indeed, hyperactivated AT1R receptors are responsible for pro-hypertension, pro-inflammation, pro-oxidation, pro-thrombosis, pro-angiogenesis, pro-hypoxemia, pro-fibrosis, pro-hypertrophy and nitric oxide. Because it has many harmful activities. falls (the latter is involved in inflammation, immunity and memory phenomena);
Overactive RAS releases the hormone aldosterone.
When RAS is overactivated, the mineralocorticoid hormone aldosterone is secreted by the adrenal glands. Aldosterone helps maintain the balance of sodium and potassium (he is two electrolytes in the body that carry a positive charge when present in body fluids, including blood). Aldosterone secretion is stimulated by angiotensin-2 or elevated blood potassium levels. Aldosterone’s role is reabsorption of sodium in the kidney (via cells in the distal tubule of the nephron) and secretion of potassium in the urine to precisely regulate blood volume and blood pressure.
Retention of water and sodium
Primarily regulating the balance of sodium, chloride and potassium, the kidneys filter approximately 800 millimoles of potassium per day. (= vascular system) retains water and sodium (in salt form). As a result, blood volume increases and blood pressure rises (hypertension). Aldosterone therefore regulates blood pressure and hydration in the human body. Therefore, RAS overactivated by SARS-CoV-2 (or even by the vaccine Spike protein in some cases) can be associated with hypokalemia, an insufficient level of potassium in the blood (< 3.5 mmol/L). ).
Hypokalemia causes disability (e.g., paralysis) in Covid-19
In general, hypokalemia can result from either insufficient potassium uptake or extracellular potassium movement within cells. In practice, hypokalemia is primarily associated with potassium loss via the urine (vomiting) or the gastrointestinal tract (vomiting or diarrhea common with Covid-19). A common cause is excessive kidney and digestive loss. Diuretic use or damage to the adrenal glands can also cause low blood potassium levels. accumulation), intake of high carbohydrate index foods that induce secretion of insulin, caffeine, theophylline, or certain drugs (including beta2 mimetic bronchodilators). Mild hypokalemia may be asymptomatic. Moderate to severe hypokalemia is associated with arrhythmias (extrasystoles, block, and ventricular/atrial tachyarrhythmias, ventricular fibrillation), malaise, severe fatigue (myalgic encephalomyelitis or chronic fatigue syndrome), muscle weakness, cramps, pain, and fasciculations/contractions, including (mostly transient) muscle paralysis. Severe hypokalemia is associated with (i) arterial hypotension, (ii) pulmonary hypoventilation (insufficient air supply to the lungs) leading to hypoxemia (decreased red blood cell oxygen saturation O2), and It can cause hypercapnia (carbon dioxide overload of arterial blood) leading to acidification. (spontaneous hypoventilation is found in some athletes) and (iii) paralytic ileus (intestinal paralysis or severe constipation corresponding to slowing or stopping of intestinal transit).
possible kidney problems
Note that hypokalemia and related pathologies can occur (via intracellular potassium mobilization mediated by the Na+/K+-ATPase pump) even when potassium levels in the body are normal. is important.
Hypokalemia-related symptoms and disorders are frequently observed in people with long-standing Covid after natural infection and/or anti-Covid-19 vaccination. Or past microbial infections (influenza virus for influenza, Epstein-Barr herpes virus for infectious mononucleosis, etc.) should be considered. Blood potassium deficiency is associated with the emergence of more or less disabling medical conditions, as this mineral is essential for the proper functioning of cells, nerves, muscles (and others). Low blood levels of magnesium (hypomagnesemia) can cause hypokalemia. Potassium deficiency can be reversed by a potassium-rich diet (or supplement) (bananas, fish, beans, potatoes, etc.). Be careful. If hypokalemia persists, the host will develop kidney problems, requiring frequent urination and drinking large amounts of water.
glucose, insulin, hypokalemia
RAS overactivated by viral spike proteins (during natural host infection with SARS-CoV-2) or possibly vaccines (vaccine-derived spike proteins) become dysfunctional. Dysfunctional RAS induces impaired glucose tolerance (type 2 prediabetes) through hyperactivation of its ‘harmful’ AT1R receptor. It has been observed that in long-term Covid patients, the consumption of high-carbohydrate foods (chocolate bars, sugar, sweets, etc.) can lead to worsening of nullification of Covid-19 medical conditions. Such foods induce the secretion (from the beta cells of the islets of Langerhans of the pancreas) of insulin, a hypoglycemic hormone involved in regulating blood sugar levels. Insulin causes hypokalemia (by stimulating Na+/H+ exchangers that increase intracellular sodium, the latter internalizing potassium (2 K+) by releasing sodium (3 Na+) into the extracellular medium). (activates the Na+/K+-ATPase pump). These events provide an element of response to potential and recurrent ‘relapses’ (unexplained to date) associated with high-carbohydrate food intake.
In summary, Hypokalemia (or low blood potassium) caused by RAS dysfunction and angiotensin-2 excess (which induces overactivation of RAS AT1R receptors) is more or less associated with many pathologies of Covid-19 and Covid long. contribute. These data are of interest for understanding and treating Covid-19 diseases, including (temporary) paralysis and chronic fatigue syndrome (myalgic encephalomyelitis).
*Jean-Marc Sabatier is Research Director at CNRS, holds a PhD in Cell Biology and Microbiology and an HDR in Biochemistry. He is editor-in-chief of the international scientific journals “Coronaviruses” and “Infectious Disorders – Drug Targets”. He speaks by his own name here.
https://frenchdailynews.com/health/8531-covid-19-potassium-responsible-for-disabling-pathologies Potassium that nullifies the pathology