Researchers review how COVID-19 affects more than the lungs
Their findings claim that beyond severe respiratory distress, coronavirus infections can cause an increased risk of heart attack and kidney failure, as well as clotting disorders.
By ZACHARY KEYSERDermatologist Marta Maria Moratinos treats patient Fernanda Zabala, holding a protective mask, at her clinic on the first day that some small businesses are allowed to open during lockdown, the coronavirus disease (COVID-19) outbreak in Madrid, Spain, May 4, 2020. "I feel thankful we have been allow(photo credit: REUTERS/SUSANA VERA)
Physicians at the Beth Israel Deaconess Medical Center (BIDMC) and Columbia University Irving Medical Center conducted a study on how COVID-19 affects the body, mainly focusing on how the respiratory infection affects more than the lungs, in order to provide clinical guidance for physicians attending to coronavirus infections."Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks biological mechanisms of the human body that are normally protective," said co-lead author Kartik Sehgal, MD, a hematology/oncology fellow at BIDMC's Cancer Center. "We hope that our review will be a comprehensive resource for physicians, nurses and other health care workers caring for patients with COVID-19, and provide impetus to consideration of all organ systems involved while developing research priorities and therapeutic strategies."Their findings, published in the medical journal Nature Medicine, claim that beyond severe respiratory distress, coronavirus infections can cause an increased risk of heart attack and kidney failure, as well as clotting disorders.They found that neurological symptoms such as headache, loss of smell, dizziness and fatigue – which have previously been cited and listed as symptoms by the CDC and the Health Ministry, among other central health organizations – occur in around a third of patients.More importantly, patients suffering from severe COVID-19 infections are at further risk for strokes caused by blood clots and delirium."Physicians need to think of COVID-19 as a multi-system disease," said Columbia cardiology fellow Aakriti Gupta, MD. "There's a lot of news about clotting but it's also important to understand that a substantial proportion of these patients suffer kidney, heart and brain damage."The study authors point to the notion that the systemic inflammation of the immune system that normally accompanies a coronavirus infection may be the root of the issue – adding that cells that line the blood vessels are further at risk due to the fact that when COVID-19 attacks blood vessel cells, inflammation tends to increase, forming blood clots big and small.The blood clots can then travel all over the body, affecting different organs at different times, "perpetuating a vicious cycle." The authors added that in severe cases, the messenger signals of the immune system may "spiral out of control," contributing further to the effects noted above."Future studies following patients who experienced complications during hospitalizations for COVID-19 will be crucial," said Columbia cardiology fellow Mahesh V. Madhavan, MD. "It really was quite astounding to see the significant ramifications this virus had on these other systems."With regard to their assumptions, the study authors noted the success of a drug named dexamethasone, a steroid meant to suppress the immune system, which they said reduced death in intubated patients by a third.
"It's a relatively new virus, and we're still learning about its long-term effects," said Sehgal. "The recognition of multi-system involvement by COVID-19 is important for optimal care of these patients while hospitalized, and to develop a comprehensive post-hospital-discharge follow-up plan."
