Internal medicine

Disease

Endothelial dysfunction

Coronavirus disease 2019 (COVID-19)

Reactive oxygen species

Infectious disease (medical specialty)

Biology

Arginase

Endothelium

Arginine

Cell biology

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Amino acid

Biochemistry

Medicine

JACC Basic to Translational Science

Current knowledge regarding mechanisms underlying cardiovascular complications in patients with COVID-19 is limited and urgently needed. We shed light on a previously unrecognized mechanism and unravel a key role of red blood cells, driving vascular dysfunction in patients with COVID-19 infection. We establish the presence of profound and persistent endothelial dysfunction in vivo in patients with COVID-19. Mechanistically, we show that targeting reactive oxygen species or arginase 1 improves vascular dysfunction mediated by red blood cells. These translational observations hold promise that restoring the redox balance in red blood cells might alleviate the clinical complications of COVID-19-associated vascular dysfunction.

Erythrocytes Induce Vascular Dysfunction in COVID-19