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The new coronavirus It has been unleashing chaos on the planet for three and a half months, with more than 2.6 million infected people and 182,000 deaths worldwide at press time, according to data provided by Johns Hopkins University.
Originated in China, it finally spread throughout the world, triggering a health crisis that until now had focused on the respiratory consequences of the pathogen, which in reality affects the entire body with unusual ferocity.
The specialized magazine Science spoke with dozens of doctors from different fields, who related to the publication the ravages that SARS-CoV-2 causes in other organs of the body.
These literally they occur from head to toe and it is even feared that the virus could spread through the excrement of the sick.
However, it is still too early and the virus and its behavior remain unknown. More research is needed to know reliably what the real scope of the disease is and much more scientific research to be able to find a cure for this particle that is progressing without brake.
Lungs
Despite this, scholars have established that angiotensin-converting enzyme 2 receptors (ACE2) would be crucial in infecting the body, since the Covid-19 takes advantage of them to enter the organism, multiply and unleash its chaos.
So, invading a single cell, has the free way to replicate itself in others.
If the immune system fails to defeat the virus in its initial phase, it moves to the respiratory system and, in summary, it generates problems in the alveoli, rich in ACE2 receptors.
The pneumonias that have been talked about so much have their origin in the battle that this cousin of SARS and MERS (who hit Asia in 2002 and the Middle East in 2012, respectively) wage in the lungs against the immune system, which produces pus, obstructs breathing and it forces some patients to be connected to mechanical ventilators in order to live.
In this section, Science mentioned that many doctors have noticed the occurrence of “Cytokine storms”, a reaction of the immune system that finally attacks all types of cells, regardless of their nature, which can lead to bleeding of blood vessels, pressure drops, clot formation and eventual general failure.
“The actual morbidity and mortality of this disease is probably based on this inflammatory response out of control ”Jamie Garfield, a pulmonologist at Temple University Hospital, told the media.
However, this hypothesis has detractors. “There seems to have been a move to associate Covid-19 with these hyper inflammatory states. I have not seen convincing data that is the case, ”shot Joseph Levitt, a specialist in critical lung care at Stanford University School of Medicine.
Heart
The heart It is another of the organs that specialists have noticed that suffers the attacks of the particular new coronavirus.
The publication reported the case of a 53-year-old woman from Italy who came to the hospital with all the symptoms of a heart attack, it was even found that the left ventricle only pumped a third of normal blood.
But heart attack nothing. Less blockage in the arteries. The patient had Covid-19 coronavirus.
How the virus attacks this vital muscle is still a mystery, but the problem has been detected in several hospitals, in different countries, which has already been published in academic journals such as JAMA Cardiology.
This can spread to the blood and cause clots, which could easily reach the lungs, killing a patient.
“The more we observe, the more likely it seems that clots play an important part in seriousness and mortality of Covid-19, ”Behnood Bikdeli, a cardiovascular specialist at Columbia University Medical Center, told Science.
This infection would also lead to constriction of blood vessels, with which appear problems in the skin, especially in hands and feet.
In conversation with BioBioChileRodrigo Loubies, a dermatologist at the University of Santiago (Usach), explained three studies that changed the way in which, until a few weeks ago, the effects of SARS-CoV-2 on the body were understood.
Specifically, all the investigations pointed out that a portion of confirmed coronavirus patients developed skin conditions apart from respiratory problems, although some did not even show such symptoms.
“At first, given the severity of the respiratory symptoms, no one noticed the skin, which can suffer erythematous rash, when a person gets whole, like little measles, “he said in the contact.
“When the university asked me how the coronavirus issue was going, we raised this issue of informing the population, to be vigilant, because suddenly one is waiting for respiratory symptoms and there are children or adolescents who are having these spots and it would be important to be evaluated, “he said.
Kidneys
As the world desperately searches for masks and access to mechanical fans, dialysis machines have not focused attention of the population so far.
“The lung is the main battle zone, but a fraction of the virus attacks the kidneys. And just like on the battlefield, if two places are under attack at the same time, each site gets worse, ”Hongbo Jia, a neuroscientist at the Suzhou Institute for Biomedical Engineering and Technology at the Chinese Academy of Sciences, told Science.
“If people are not dying of lung failure, they are dying of kidney problems ”said Jennifer Frontera, a neurologist at the Langone Medical Center at New York University.
Indeed, the kidneys are another crucial point for infection, as these are rich in ACE2 receptors. Thus, the pathogen becomes a real threat to patients with kidney diseases prior to this pandemic, said Suzanne Watnick, chief of the specialty at Northwest Kidney Centers.
Brain
Doctors mainly from the United States, the country most affected by the virus, began to notice that apart from the aforementioned symptoms, some patients were disoriented.
Well, they found that the coronavirus impacts the brain and therefore to the nervous system.
French doctors studied 58 patients with Covid-19 and established that half of them were disoriented or agitated, thus scanners they threw possible inflammations.
Their findings were published through an article in the New England Journal of Medicine, the most prestigious medical magazine in the United States.
Meanwhile, another article published in the journal of the American Medical Association indicated that 36% of a group of 214 Chinese patients observed by health specialists had neurological symptoms such as loss of smell, neuralgia, seizures and strokes.
“Everyone says it is a breathing problem, but it also affects what matters most to us: the brain,” S. Andrew Josephson, head of the department of neurology at the University of France, told Agence France-Presse (AFP). California in San Francisco.
Along the same lines, Rohan Arora, a neurologist at Long Island Jewish Forest Hills Hospital, reported that in their daily work they see “many patients disoriented.”
Both the neuronal cortex and the brain stem have ACE2 receptorsBut what is not yet known is how or where SARS-CoV-2 enters these structures, according to Robert Stevens, an intensive care physician at Johns Hopkins University.
What is known is that the coronaviruses behind the epidemics of 2002 and 2012 infiltrated neurons and, on some occasions, caused encephalitis, that is, inflammation of the brain.
Intestinal tract
The intestinal tract It is another area of the human body that the health world has noticed that it can suffer with the new coronavirus.
One of the many cases reported was that of a 71-year-old Michigan patient who returned from a cruise on the Nile River in early March with bloody diarrhea, vomiting, and abdominal pain.
It was only when she began to show a cough that the doctors ruled out that it was something purely stomach and subjected her to a PCR test. Et voilà, positive for coronavirus.
According to Science, samples taken from its droppings also tested positive for viral RNA and new examinations showed that he had a wound in the colon, which was associated with a coronavirus-derived gastrointestinal infection, according to a study published in The American Journal of Gastroenterology (AJG).
The experience of the tourist connected ends for many, if we take into account that Covid-19 is a cousin of SARS, like its relatives, this new pathogen can infect the lower gastrointestinal tract where ACE2 receptors can also be found.
This is where medical experts say they are concerned about the possibility that effectively the feces of a sick person spread to those who are not.
But since everything about this virus is not yet known, cannot be sure for certain whether it will happen or not.
To date “we have no evidence” that fecal transmission is important, Stanley Perlman, a coronavirus expert at the University of Iowa, told Science.
However, based on experience with SARS and MERS, the Centers for Disease Control and Prevention in the United States is currently considering that the risk that this is another form of contagion “is low”.
In addition to all of the above, the publication reported that a third of patients hospitalized for Covid-19 in the United States developed some degree of conjunctivitis.
Although it is already understood that the virus can enter the body through the eyes, it has not yet been confirmed that it directly attacks the eyeballs.
“Other reports suggest liver damage: More than half of patients hospitalized for Covid-19 in two Chinese healthcare centers had elevated levels of enzymes, indicating liver or bile duct problems, “they wrote.
“But experts told Science that direct viral invasion was possibly not the real culprit. They claimed that other events in a failed body, such as medications or an uncontrolled immune system, were more capable of causing liver damage, “they concluded.
We could have been more prepared
With everything, too little time has passed for science and humanity to fully understand what we are dealing with, which is why finding an antibody or vaccine emerges as the desired goal at a time when the planet has stopped before the outbreak of this new disease.
Despite this, the world could have been more prepared for a catastrophe of this magnitude, but it did not happen for a simple reason: money.
It was 2002 and the disease that was finally baptized as SARS affected 29 countriesIt infected almost 10,000 people and killed about 800 patients due to respiratory complications.
Ten years later, in 2012, another coronavirus emerged: the MERS. In its peak was completely circumscribed in the Middle East and to date, according to the WHO, it has caused 2,494 cases and 858 deaths in 27 countries.
As both outbreaks were controlled relatively on time and affected specific areas, governments, health authorities and laboratories ruled out funding or completing vaccine studies that were made or commissioned.
The current scenario is diametrically distant from what was experienced previously and the race to find a cure for SARS-CoV-2 is in full swing.
Therefore, both Asia, Europe and the United States fight side by side to obtain it first. Even the immunologist Jacob Glanville (Pandemic, Netflix) intends to launch an antibody before any immunization.
But Texas Children’s Hospital Vaccine Development Center produced a SARS vaccine in 2016.
This was recalled in conversation with the BBC María Elena Bottazzi, co-director of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, the same position she holds at the center in question.
“We had finished the trials and had gone through the critical aspect of creating a pilot scale production process for the vaccine,” he told the newspaper.
“So we went to the NIH (US National Institutes of Health) and asked them: ‘What do we do to quickly move the vaccine to the clinic?’ And they said: ‘Look, right now we are no longer interested’ ”, he pointed.
Susan Weiss, professor of microbiology at the University of Pennsylvania, recalled that 7 to 8 months after the end of the epidemic, the agents who had to support research on cures “Immediately lost interest in the study of coronaviruses”.
“SARS mainly affected Asia, with a few cases in Toronto, but it did not reach Europe like this new coronavirus. Then came MERS, the second virulent human coronavirus, and that one was almost totally confined to the Middle East, “he stressed.
“Then the coronaviruses and interest in them dissipated. Until now. And I really think we should have been better prepared, “the academic told the London network.
“We would have already had an example of how these types of vaccines behave And although viruses are not exactly the same, they come from the same class. We would already have the experience of seeing where problems arise with the vaccine and how to solve them. Because we have already seen how the SARS vaccine behaved pre-clinical and we would expect the new vaccine to behave relatively the same, “Bottazzi told the BBC.
“Already we could have had a human safety profile and more confidence that these vaccines can be used in populations that need them, “he added.
But the case is different in animals. A deadly outbreak in the food industry would mean multimillion-dollar losses for this productive sector, which is why coronaviruses in animals are very well studied, with vaccines for several species.
“The reality is that when there is a market there is a solution. Today we have hundreds of coronavirus vaccines, but they are all for animals: pigs, chickens, cows ”Peter Kolchinsky, virologist and director of the biotech company RA Capital, explained to the BBC.
All in order to curb diseases that can be onerous for the poultry and livestock industry, fears that never applied to humanity. Until now.
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