If you had told me in March, when the viral pandemic began, that we’d still be staying inside 5 months later, I wouldn’t believe you. Yet COVID-19 has become one of the most prevalent parts of our lives this year. Originating in Wuhan, China, COVID-19 has now spread across the globe. In the United States alone, there are 5.51 million diagnosed cases and 172,000 associated fatalities. Yet each and every day, researchers learn more and more about this virus. According to Medical XPress, a recent clue on how the virus affects the lungs was found based on microbubbles and a robotic Doppler system.

It all began when neurologist Dr. Alexandra Reynolds was checking the health of patients with COVID-19 who fell into a coma. While checking their vitals, to ensure that patients did not have a stroke, she heard something strange. The sound? Microbubbles flowing through patients’ blood. Eventually, her research uncovered a deeper understanding of COVID-19 related lung damage. You can check out her findings in American Journal of Respiratory and Critical Care Medicine.

COVID-19: What We Know

Over the past few months, news of COVID-19 has dominated the headlines. From New Zealand having their first cases in over 100 days, to the viral pandemic spreading as far as indigenous Amazon tribes, something new almost always seems to be popping up. There are over 22 million diagnosed cases worldwide, and 783,000 people perished.

As drug developers rush to create a vaccine, researchers are learning more about the virus, how it reacts, and its symptoms. Currently, symptoms include:

• Fever and chills
• Loss of smell and taste
• A persistent, hacking cough
• Difficulty breathing
• Intense fatigue and muscle aches
• Headache
• Sore throat
• Congestion
• Nausea, vomiting, and diarrhea
• Chest pressure
• Confusion
• Blue lips or face

Symptoms generally appear within 2 days to 2 weeks of infection. The CDC believes COVID-19 usually lasts for around 2-3 weeks. However, as reported by Patient Worthy in early June, there is a patient population called “long haulers” whose symptoms persist for months following infection.

While doctors are not sure what the lasting effects of COVID-19 are, many believe that there will be related health issues resulting from organ damage, lung scarring, and stroke.

Dr. Reynolds’ Findings

This spring, the intensive care unit (ICU) at Mount Sinai Hospital quickly filled with patients with COVID-19. Those in the ICU had severe infections. Many required both sedation and ventilation. However, doctors worried about monitoring patients for brain damage. At first, checking pupils was the only avenue towards assessing brain function. While a transcranial Doppler was a potential response, it required healthcare workers to spend large amounts of time with one patient. Because of the sheer number of patients, this was neither appropriate nor desired.

Then Dr. Reynolds had an idea: a robotic Doppler. Normally, a transcranial Doppler assesses blood circulation in the brain by monitoring ultrasound waves. However, a robotic Doppler automatically monitors brain health. Dr. Reynolds used the robotic Doppler to perform a “bubble study.” In these studies, doctors inject saline with microbubbles into someone’s vein. Capillaries, or fine blood vessels in the lungs, normally capture these bubbles and remove them from the bloodstream. Seeing how these bubbles act within the body can give doctors a better idea of a patient’s stroke risk.

As Dr. Reynolds began performing bubble studies on patients with severe COVID-19, she noticed something strange. The microbubbles were not being filtered out of the blood. Instead, they were reaching patients’ brains. Usually, this only happens if patients have a heart defect; bubbles can escape through this. But she was pretty sure that not every patient in the ICU had a heart defect.

How COVID-19 Affects Capillaries

Could capillaries be unnaturally dilated (expanded), resulting in patients not getting enough oxygen? Dr. Hooman Poor believed so. Together, Dr. Poor and Dr. Reynolds ran a study on 18 patients. Of these, 15 had microbubbles in their brain. Those with the most bubbles also struggled the most for oxygen. On one hand, patients with COVID-19 who require ventilation often have acute respiratory distress syndrome (ARDS). Yet this is caused by lung stiffening and fibrosis not usually associated with COVID-19.

As a result, Dr. Poor hypothesized that COVID-19 causes blood clots by attacking the lining of blood vessels. As a result, blood moves to dilated vessels and moves too quickly to absorb oxygen. Admittedly, more research is needed to determine whether or not this is true. However, it does give some insight into what may be happening in the lungs.