‘We thought this was just a respiratory virus’: the standard

A health worker cares for a patient infected with coronavirus disease (COVID-19), inside an Intensive Care Unit of the clinical hospital of the University of Chile in Santiago, Chile, June 18, 2020. (Reuters)

According to infectious disease doctors and experts, scientists are just beginning to understand the wide variety of health problems caused by the new coronavirus, some of which may have persistent effects on patients and health systems for years to come . In addition to respiratory problems that leave patients breathless, the virus that causes Covid-19 attacks many organ systems, in some cases causing catastrophic damage. “We thought this was just a respiratory virus. Turns out it goes after the pancreas. It goes after the heart. It goes after the liver, brain, kidney, and other organs. We didn’t appreciate that at first, ”said Dr. Eric Topol, cardiologist and director of the Scripps Research Translational Institute in La Jolla, California. In addition to respiratory distress, patients with Covid-19 may experience blood clotting disorders that can lead to strokes and extreme inflammation that attacks multiple organ systems. The virus can also cause neurological complications ranging from headache, dizziness, and loss of taste or smell to seizures and confusion.

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And recovery can be slow, incomplete, and expensive, with a major impact on quality of life. The wide and diverse manifestations of Covid-19 are somewhat unique, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine in Chicago. With the flu, people with underlying heart conditions also have an increased risk of complications, Khan said. What is surprising about this virus is the extent of complications that occur outside the lungs. Kahn believes that there will be a great expense and burden of medical care for people who have survived COVID-19.
Long-term rehabilitation for many

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Patients who have been in the intensive care unit or on a ventilator for weeks will need to spend a lot of time in rehabilitation to regain mobility and strength. “It can take up to seven days for every day that you are hospitalized to regain that kind of strength,” Kahn said. “It’s harder the older you are, and you may never go back to the same level of function.” While much of the focus has focused on the minority of patients experiencing severe illness, physicians are increasingly seeking the needs of patients who were not sick enough to require hospitalization but still suffer months after becoming infected. for the first time. Studies are being started to understand the long-term effects of the infection, Jay Butler, deputy director of infectious diseases at the US Centers for Disease Control and Prevention, told reporters in a conference call Thursday. . “We hear anecdotal reports of people having persistent fatigue, shortness of breath,” Butler said. “How long will that last is hard to say.”

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While coronavirus symptoms generally resolve within two to three weeks, an estimated 1 in 10 experience prolonged symptoms, Dr. Helen Salisbury of the University of Oxford wrote in the British Medical Journal on Tuesday. Salisbury said many of her patients have normal chest x-rays and show no signs of inflammation, but have not yet returned to normal. “If you previously ran 5k three times a week and now feel breathless after a single flight of stairs, or if you cough endlessly and are too exhausted to return to work, then the fear that you will never regain your former health is very real, “she wrote. Dr. Igor Koralnik, chief of neuroinfectious diseases at Northwestern Medicine, reviewed the current scientific literature and found that approximately half of the hospitalized patients with COVID-19 had neurological complications, such as dizziness, decreased alertness, difficulty concentrating, smell and taste disorders, seizures, strokes, muscle weakness and pain. Koralnik, whose findings were published in Annals of Neurology, has started an outpatient clinic for Covid-19 patients to study whether these neurological problems are temporary or permanent.

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Kahn sees parallels with HIV, the virus that causes AIDS. Much of the initial focus focused on deaths. “In recent years, we have focused a lot on the cardiovascular complications of HIV survival,” said Kahn.