Damage from COVID-19 beyond the lungs

The disease caused by the SARS-CoV-2 coronavirus (COVID-19) continues to be surrounded by many unknowns. For now, everything points to the lungs being the main organs in which the ravages of this infection are shown. But beyond these, its reach could extend to different organs, including the heart and blood vessels, the liver, kidneys, intestine, and brain. This is summarized by a recent article published in the journal Science, which explains how different studies are trying to track the damage that COVID-19 leaves on the human body.

COVID-19 was first known as a form of pneumonia. We know that this is a viral infection that attacks the respiratory system (where it damages the alveoli’s ability to absorb oxygen) and tests the immune system (which struggles to counteract it). Hence, infected patients may suffer symptoms such as fever, cough, respiratory difficulties and, in the most severe cases, the so-called Severe Acute Respiratory Syndrome (SARS). Many of the studies published to date focus on these two battlefields, the body’s system of defenses against an eventual attack and the organ that, if attacked, shows a fatal outcome of the disease.

In this sense, if we take the results of some of the studies published to date, the result is as follows. More than half of the patients hospitalized for COVID-19 show liver damage or signs of liver overexertion (which could be explained by infection, the action of the immune system, or the side effect of medications).

On the other hand, kidney involvement seems to be increasingly frequent in patients with a severe infection. In addition, analysis of the intestine of some infected people suggests that the infection also affects the gastrointestinal tract. According to one preprint, 27% of 85 hospitalized patients in Wuhan had kidney failure. Another reported that 59% of nearly 200 hospitalized COVID-19 patients in China’s Hubei and Sichuan provinces had protein in their urine, and 44% had blood; both suggest kidney damage. Those with acute kidney injury (AKI), were more than five times as likely to die as COVID-19 patients without it, the same Chinese preprint reported. But kidney injury may also be collateral damage. Ventilators boost the risk of kidney damage, as do antiviral compounds including remdesivir, which is being deployed experimentally in COVID-19 patients. Cytokine storms also can dramatically reduce blood flow to the kidney, causing often-fatal damage. And pre-existing diseases like diabetes can increase the chances of kidney injury.

Besides, some diagnosed patients have experienced strokes, epileptic seizures, and other brain conditions.

Moreover, conjunctivitis and inflammation of the ocular membranes have also been reported in patients with a severe diagnosis. Recent work published in The Lancet also suggests that this disease also affects the vascular system, severely damaging the blood vessels and the heart.

However, it will take years of research to fully understand the extent of COVID-19 disease and the cascade of cardiovascular and immunological effects it could set in motion, the authors conclude.

Link to the paper: https://doi.org/10.1126/science.abc3208

Editorial Disclaimer: information published during the 2020 COVID-19 pandemic may be updated frequently to reflect the dynamic nature of current understanding.

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