Doctors are finding damage in kidneys, hearts and elsewhere by COVID-19

The coronavirus kills by inflaming and clogging the tiny air sacs in the lungs, choking off the body’s oxygen supply until it shuts down the organs essential for life.

But clinicians around the world are seeing evidence that suggests the virus also might be causing heart inflammation, acute kidney disease, neurological malfunction, blood clots, intestinal damage and liver problems, among others.

However, the prevalence of these effects is too great to attribute them solely to the cytokine storm ―the uncontrolled response that leads to the release of a flood of substances called cytokines that, in excess, can result in damage to multiple organs―, doctors and researchers said.

In this way, almost half the people hospitalized because of COVID-19 have blood or protein in their urine, indicating early damage to their kidneys. Even more alarming, is early data that show 14 percent to 30 percent of intensive-care patients in New York and Wuhan have lost kidney function and require dialysis, or its in-hospital cousin, continuous renal-replacement therapy. Still, when researchers in Wuhan conducted autopsies on people who died of COVID-19, they found nine of 26 had acute kidney injuries and seven had particles of the coronavirus in their kidneys, according to a paper by the Wuhan scientists published April 9 in the medical journal Kidney International.

Besides, the virus also might be damaging the heart. Clinicians in China and New York have reported myocarditis, an inflammation of the heart muscle, and, more dangerous, irregular heart rhythms that can lead to cardiac arrest in COVID-19 patients. One review of severely ill patients in China found that about 40 percent suffered arrhythmias and 20 percent had some form of cardiac injury.

Moreover, the unfettered response, also called cytokine release syndrome, has long been recognized in other patients, including those with autoimmune diseases, such as Rheumatoid Arthritis (RA), or in cancer patients undergoing certain immunotherapies.

Another odd, and now well-known, symptom of COVID-19 is loss of smell and taste. However, anosmia ―the medical term for the inability to smell―, was not initially recognized as a symptom of COVID-19, surely because doctors were so overwhelmed by patients with severe respiratory problems. But subsequent data from a symptom-tracking app have shown that 60 percent of people later diagnosed with COVID-19 reported losing their senses of smell and taste. In this way, about a quarter of participants experienced anosmia before developing other symptoms, suggesting it can be an early warning sign of infection.

There also are reports that COVID-19 can turn people’s eyes red, causing pink eye, or conjunctivitis, in some patients. One study of 38 hospitalized patients in Hubei province, China, found that a third had pink eye.

Finally, the virus also is having a clear impact on the gastrointestinal tract, causing diarrhea, vomiting and other symptoms. One study found that half of COVID-19 patients have gastrointestinal symptoms. The new coronavirus enters the cells of people who are infected by latching onto the ACE2 receptor on cell surfaces. It unquestionably attacks the cells in the respiratory tract, but there is increasing suspicion that it is using the same doorway to enter other cells. The gastrointestinal tract, for instance, contains 100 times more of these receptors than other parts of the body, and its surface area is enormous.

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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