(CNN) — He coronavirus It damages not only the lungs, but also the kidneys, liver, heart, brain and nervous system, skin and gastrointestinal tract, a medical team said Friday in a review of reports on patients with covid-19.
The team at Columbia University Irving Medical Center in New York City, one of the hospitals that treated the most patients in the spring, went through their own experiences and compiled reports from other medical teams around the world.
its image Complete shows that the coronavirus attacks virtually all major systems in the human body, directly affecting the organs and causing the blood to clot, the heart to lose its healthy rhythm, the kidneys to lose blood and protein, and the skin to erupt into rashes. It causes headaches, dizziness, muscle aches, stomach pain, and other symptoms along with classic respiratory complications like cough and fever.
“Clinicians should think of covid-19 as a multi-system disease,” said Dr. Aakriti Gupta, a Columbia cardiology researcher who worked on the review, in a statement. “There’s a lot news about coagulation, 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 the damage caused by the virus appears to come from its affinity for a receptor, a kind of molecular gateway to cells called ACE2. The cells that line the blood vessels, kidneys, liver ducts, pancreas, intestinal tract, and lining of the respiratory tract are covered with ACE2 receptors, which the virus can use to grab and infect cells, the Columbia team wrote in his review, published in the revista Nature Medicinee.
“These findings suggest that multi-organ injury may occur at least in part due to direct damage to viral tissue,” the team wrote.
Coronavirus infection also activates the immune system. Part of that response includes the production of inflammatory proteins called cytokines. This inflammation can damage cells and organs, and the so-called cytokine storm is one of the causes of severe symptoms.
“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,” Dr. Mahesh Madhavan, another cardiology colleague who worked on the review, said in a statement.
The effects of blood clotting appear to be caused by several different mechanisms: direct damage to the cells that line the blood vessels and interference with the various coagulation mechanisms in the blood itself. The low oxygen level in the blood caused by pneumonia may make the blood more likely to clot, the researchers say.
These clots can cause strokes and heart attacks, or they can lodge in the lungs or legs. They cover the kidneys and interfere with the dialysis treatments necessary for the most affected patients.
Damage to the pancreas can worsen diabetes, and patients with diabetes have been shown to be at the highest risk for severe disease and death from coronavirus.
The virus can directly harm the brain, but some of the neurological effects probably come from treatment. “Patients with covid-19 can be intubated for two to three weeks; a quarter requires fans for 30 days or more, “said Gupta.
“These are very long intubations and patients need a lot of sedation. “ICU delirium” was a well-known condition before covid, and hallucinations may be less an effect of the virus and more an effect of prolonged sedation. “
The virus affects the immune system, depleting T cells that the body often deploys to fight viral infections. “Lymphopenia, a marker of impaired cellular immunity, is a cardinal laboratory finding reported in 67-90% of covid-19 patients,” the researchers wrote.
Doctors must treat all of these effects when coronavirus patients show up at the hospital, the Columbia team said.
There is some good news.
“Gastrointestinal symptoms may be associated with longer disease duration, but have not been associated with increased mortality,” the researchers wrote. Many of the effects on the skin, such as rashes and swollen, purple “covid toes,” also go away on their own.
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