Patient 3: 69 year-old man
- High blood pressure
- Respiratory failure due to COVID-19
- Was put on a mechanical ventilator
- Experienced restricted blood flow in vessels
- Endotheliitis in small intestine
- Apoptotic bodies in small intestine
- Patient survived

Michigan State University

- Inflammation of endothelial cells in the heart, lung, and small bowel
- A COVID-19 patient's kidneys were unable to filter blood and necrosis was present in the small intestine
- Another COVID-19 patient was found to have inflammation in the endothelial layer of the small intestine
- ACE2 receptors are used by the COVID-19 virus in the epithelial alveolar lining of the lungs, resulting in lung damage
- ACE2 receptors are located on endothelial cells, which are located in other organs and can negatively impact them
- Image shows an excess of mononuclear cells in the lung, resulting in the blockage of the small vessels in the lung


Effects of the ACE2 receptors on organ tissues of COVID-19 patients

Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., ... & Moch, H. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet, 395(10234), 1417-1418.

Endothelial cell infection and endotheliitis in COVID-19

Patient 1: 71 year-old male
- Had undergone renal transplant
- Coronary artery disease and high blood pressure in the arteries
- Needed mechanical ventilation
- Died after 8 days
- In post-mortem, it was found that there was inflammation of the endothelial layers of the heart, lung, and small bowel
- Apoptosis, or programmed cell death, was present in the heart, lungs, and small bowel
- Build up of cells in small vessels of the lung


Patient 1

Patient 2: 58 year-old female
- Presented with diabetes, high blood pressure, and obesity
- Experienced respiratory and multi-organ failure
- Underwent renal replacement
- After 16 days, the necrotic tissue of the small intestine was found and removed after blood flow to that area was lacking
- Heart failure; died of cardiac arrest
- Endotheliitis was present in the lung, kidney, liver, and heart in post-mortem
- Necrotic tissue present in liver


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