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Not all patients survive a coronavirus infection without consequent damage. The extent of this is still not entirely clear. However, initial reports have surprised doctors.
In addition to the ugly number, the number of the dead, there is also a good one in the crown pandemic: the number of those who have recovered. Nearly 100,000 people in Germany have been shown to be infected with Sars-CoV-2 and have defeated the virus. And yet, not everyone who has recovered is healthy. Because Covid-19 does not always heal without consequences. Some patients will have to deal with the consequences of the infection for quite some time, some for life.
“In general, we still know very little about the possible long-term consequences, the disease is still too young for that,” says Peter Berlit, Secretary General of the German Society for Neurology. But doctors in many countries around the world are feeding databases with their findings so they can make better forecasts in the future. They represent a wide variety of disciplines, because the corona virus can harm the body in various ways.
One of the focal points of the research is in the lungs, after all, Covid-19 is primarily a lung disease. “We currently assume that most patients will make a full recovery,” says Michael Pfeifer, president of the German Society of Pulmonology and Respiratory Medicine. However, some patients, especially those who had to be treated in the hospital, have restricted lung function even weeks after no virus is detected in their body and are considered healthy. The tissue is so damaged that the lungs can no longer do their job completely. “We currently don’t know if this will heal or if permanent damage will persist,” says Pfeifer.
“In most patients, these symptoms resolve within four weeks.”
But the pulmonologist also gives hope. Basically, the lungs are very regenerative, so patients should not be too impatient. It is quite normal for the lungs to take a few months to recover after severe acute illness. “As a doctor, you’re always amazed at how well your lungs can recover,” says Pfeifer. This applies even after ventilation in the intensive care unit, which is always a burden on the lungs. “But even after that, only a few patients have severe long-term lung restriction.”
Other specialists also know of complications that may persist. For example, neurologists have recently been surprised by reports from Italy that individual Covid 19 patients developed Guillain-Barré syndrome, an inflammatory disease of the nerves that can lead to progressive paralysis. “This disease arises as a result of the immune response to infection,” says neurologist Peter Berlit. This is also known from other infections. The body forms excess antibodies against pathogens, which then, as a kind of medical collateral damage, damage the nerves.
Flu is more likely to cause loss of odor. Could be similar with Corona
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Sars-CoV-2 can also attack the brain and nerves directly. It is now known that many patients lose their sense of smell and taste because the virus damages the olfactory nerve. “In most patients, these symptoms resolve within four weeks,” says Berlit. But since the flu can also lead to permanent loss of odors, experts assume, “Some Covid patients may also retain something like this.”
The virus was found in nervous water in several patients, for example, in a 24-year-old Japanese who suffered epileptic seizures as a result of his corona infection. In Italy, some patients with a crown mainly showed neurological symptoms such as headache, nausea, and altered consciousness. Finally, strokes frequently occur in severely affected Covid patients. Because both the virus itself and the immune response against the pathogen can damage the vessels, which in turn favors a stroke. Added to this is the lack of oxygen and the activation of the coagulation system as a result of the disease, which also promote a stroke. “The number is not large; in China, for example, there were six strokes in a case series of 214 patients,” says Berlit, but here the burden of long-term consequences is often heavy.
The heart could also be permanently affected by the corona virus. “We see some with severe troponin eruptions in hospitalized patients with Covid-19,” says Andreas Zeiher, president of the German Society of Cardiology. This indicates that the heart muscle cells are dying. There are some optimistic reports from China that the heart is recovering from it, “but we hear from Italy that the function of the pump remains restricted in some patients.” Damage to the heart could be the reason why cardiac patients often experience a particularly severe corona infection. But there have also been reports of previously heart-healthy people who only had heart problems as a result of the infection.
For the cardiologist, this leads to two conclusions: The consequences of Covid-19 would have to be carefully investigated to treat patients as well as possible. To this end, those who have recovered must be carefully accompanied. Zeiher is also concerned about the Covid therapies that are currently being tested. Because they have some adverse side effects on the heart.
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