The more scientists learn about Covid-19, the clearer it is that it is not just an “unpleasant cough” that affects the respiratory system. An increasing amount of evidence shows that the new coronavirus can affect a variety of vital organs beyond the lungs, including the kidneys, heart, intestine, brain, and more.
In April, doctors at Columbia University Irving Medical Center (CUIMC) in New York City, the epicenter of the US coronavirus outbreak At the time, began to notice that many of their patients with Covid- 19 showed much more than respiratory symptoms. Based on their own experiences and dozens of medical reports from around the world, they have now published the first extensive review of Covid-19’s effects on all affected organs outside of the lungs.
Reported in the newspaper Nature medicine, The team presented all the known information about how Covid-19 affects everything from the skin and brain to the blood-forming organs and kidneys.
“Physicians should think of COVID-19 as a multi-system disease,” said Aakriti Gupta, lead author and CUIMC cardiologist, in a statement. statement.
“There is a lot of news about clotting, but it’s also important to understand that a substantial proportion of these patients suffer from kidney, heart and brain damage, and doctors must treat those conditions along with respiratory disease.”
Much of these complications are related to inflammation and blood clots. The virus is also known to create an intense “runaway” response from the immune system. While the immune response is intended to help flush the infection out of the body, it can kick-start effectively and cause moderate inflammation. Clots are a prominent effect of the disease, the researchers say, because of the way the virus attacks the cells that line blood vessels. Once a blood clot has formed, it can travel throughout the body through the blood vessels and cause problems for other organs, especially the heart, where it can cause cardiac arrest.
Beyond blood clots, the virus also appears to directly affect the heart, although no one is sure exactly how it does it.
“The mechanism of cardiac damage is currently unclear, since the virus has not been isolated frequently from cardiac tissue in autopsy cases,” added Gupta.
Another key feature of Covid-19 infection is damage to the kidneys. The research team says they saw kidney failure in about half of Covid-19 hospitalized patients, with 5-10 percent requiring dialysis, a procedure to remove waste products and excess fluid from the blood when kidneys stop working properly. This is most likely to do with the ACE2 receptor, a molecular gateway used by the virus to enter cells in high concentrations in the kidney.
Neurological symptoms – such as headache, dizziness, fatigue, loss of smell and even hallucinations – can occur in about a third of patients. Strokes are also known to occur in up to 6 percent of severe cases. Although the mechanism behind this is hazy, blood clots and inflammation are the main culprits.
Fortunately, there was some (kind of) news of relief. The document found that symptoms affecting the skin tend to be relatively mild, and the gastrointestinal problems associated with Covid-19 appear to resolve with few problems.
“This virus is unusual and it is difficult not to step back and not be impressed by the number of manifestations it has on the human body,” said co-author Mahesh Madhavan, MD, also a member of cardiology at CUIMC.
