The red blood cells contain a full complement of sodium transporters and cotransporters and
since the RBC plasma membranes were utilized initially in the early studies of sodium transport, I am thinking that sodium transport may be involved once the SARS-CoV-2 binds to the red blood cells via CD147 once it has established the viremic stage of end-organ or distant organ infection i.e. heart kidney vessel and brain and skeletal muscle with marked muscular pain reported by individuals with early COVID-19.
The red blood cell(s) (RBC) are unique in that they are anuclear and do not contain a nucleus that is required for SARS-CoV-2 virus to replicate and therefore RBCs may act as a carrier vehicle to spread the disease to other organs in addition to the WBCs.
Viremia or Virion sepsis is a multi-step process that can be supported with both light and electron microscopy.
RBCs have numeruous receptors and channels on them and I am interested in the eNOS enzyme
and if it has the capibility to secrete No from the eNOS enzyme to assist in normal endothelial cell function...??? Also since SARS-CoV-2 can cause hemoglobin to split into toxic heme and iron and result in hypercoagulopathy state that we need to learn more about RBC physiology especially as it pertains to the COVID-19 pandemic.
This discussion and or question is now open for any and all comments and suggestions as to how to proceed with this fascinating concept.
Melvin R Hayden
University of MIssouri School of Medicine
Columbia, Missouri
I did not find a scientific article referring to the role of sodium in COVID-19 infection.
Dear Melvin R Hayden
please find the following link.
Article COVID-19: Hemoglobin, Iron, and Hypoxia beyond Inflammation....
Palem Harinath,
Thank you for the wonderful review and link!
This paper really advances my initial thoughts and I am so happy that you shared this paper with me and others who are interested in this thread discussion.
I have noted impaired Rheology, Increased adhesiveness of red blood cells and increase Rouleaux formation with aggregation in multiple end-organs of type 2 diabetes preclinical models of T2DM such as in the db/db model of obesity, insulin resistance and T2DM with transmission electron microscopy studies over the years. The adhesion of RBCs to the endothelium suggests a flipping of the phosphatidylserine to the outer surface or leaflet of the RBCs plasma membranes in T2DM and increased adherence.
Cell Death Differ. 2016 Jun; 23(6): 952–961.Published online 2016 Feb 19. doi: 10.1038/cdd.2016.7PMCID: PMC4987739PMID: 26891692
Exposure of phosphatidylserine on the cell surface
S Nagata,1,* J Suzuki,1 K Segawa,1 and T Fujii1
I wish to thank all of the above followers of this discussion thread.
Melvin Hayden
This paper may be of interest to those who are interacting with this discussion:
Red blood cell abnormalities and hypertension by Kazushi Tsuda in:
Hypertension Research (2020) 43:72–73.
https://doi.org/10.1038/s41440-019-0353-0
Red blood cell distribution width (RDW), a measure of variation of RBC size, ( is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). might be a predictor of cardiovascular and cerebrovascular diseases [17, 18]. Also, RDW has also been found in those with T2DM.
- Diabetes Metab Syndr Obes by Aml Mohamed Nada
- v.8; doi: 10.2147/DMSO.S85318 2015
- PMC4634828
Does anyone feel that there may be a mineralocorticoid-like effect on the RED BLOOD CELL in regards to the RBC sodium channel since there is no nucleus in the RBC to translocated any signal as in other MR sensitive cells? especially since the sodium channels on the RBCs are involved with sodium flux into the RBCs.... just curious
Today I thought that I would upload the recent preprint discussing the lymphatic system in relation to Viremia in section 3 of this preprint. This paper has been submitted for publication; however, it may be awhile before author learns of its destiny... the opportunity to present this paper was offered in preprints so I took this opportunity.
3. Viremia: The Lymphatic System
This is in regards to the statement in the original question: Viremia or Virion sepsis is a multi-step process that can be supported with both light and electron microscopy.
This preprint paper is open for discussion to all
Sincerely and wishes for a HAPPY NEW YEAR TO ALL
Melvin R. Hayden, MD
University of Missouri School of Medicine
Columbia, Missouri USA