The virus does more damage than just the lungs

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When the lungs do insufficient work to deliver oxygen to the body, the heart may be exposed to intense stress and weaken. It is usually sufficient for diseases that cause respiratory problems. However, if even a person without dyspnea suffers damage to the heart, one must wonder if doctors underestimate the ability of COVID-19 to cause sustained destruction.

“COVID-19 is not just a respiratory disease,” said Dr. Harlan Krumholtz, a cardiologist at Yale University. “It can affect the heart, liver, kidneys, brain, endocrine and blood systems.”

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No long-term survivors of this completely new disease: Even the first victims in China are less than three months away from their trials. In addition, doctors were busy treating acute illness and were unable to carefully monitor the progress of approximately 370,000 people worldwide known to have recovered from COVID-19.

Nevertheless, doctors are worried as a result that some organs whose function has been censored from the kilter do not recover quickly or completely. This can increase the vulnerability of the patient over the next few months or years.

“I think there will be long-term sequelae,” said Yale cardiologist Dr. Joseph Brennan, who said he is using medical terms for the downstream effects of the disease.

“I don’t know if that is true,” he warned. “But the disease is so overwhelming,” he said that some of the recovered people are likely to face ongoing health problems.

Another question that can take years to answer is whether the SARS-CoV-2 virus that causes COVID-19 goes dormant in the body for years and then returns in another way later. .

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It wouldn’t be the first virus to behave that way. For example, after a chickenpox infection, the disease-causing herpes virus quietly hides for decades and manifests as a painful, painful shingles. The virus that causes hepatitis B can seed liver cancer years later. And in the months after Ebola in West Africa subsided in 2016, the virus responsible for the disease remained in the vitreous humor of some of the victim’s eyes, affecting 40% of affected people. It has been found to cause blindness or visual impairment.

Given the affinity of SARS-CoV-2 for lung tissue, doctors immediately suspected that some of the recovered COVID-19 patients may sustain persistent lung damage. Severe acute respiratory syndrome, or an infection involving coronavirus that causes SARS, caused pulmonary dysfunction after 3 years in about one-third of those who recovered, but those symptoms almost disappeared after 15 years. Did. Researchers have found that one-third of patients suffering from the Middle East respiratory syndrome (MERS) have scarring (fibrosis) in their lungs, which is probably permanent.

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A mid-March review of 12 COVID-19 patients discharged from a Hong Kong hospital explained that two or three had problems with past activity.

Some patients may “fall 20-30% in lung function” after recovery, said Dr. Owen Zentaquin, who is responsible for infectious diseases at Princess Margaret Hospital in Hong Kong.

A team led by Melina Hosenny, a radiologist at the University of California, Los Angeles, cites a history of persistent lung damage in patients with SARS and MERS, and recommends a long-term lung scan for patients who recover from COVID-19. I am. Permanent lung damage, including fibrosis. ”

There are significant complications when doctors try to assess organ damage after recovery of COVID-19. Patients with disorders that affect the heart, liver, blood, and lungs are at an increased risk of becoming very ill with COVID-19 in the first place. This makes it difficult to distinguish the sequelae of COVID-19 from those that make patients vulnerable from the start, especially early in the game.

“We’re all in the middle,” said Dr. Kim Williams, a cardiovascular specialist at Rush University Medical Center in Chicago. “We have more information about what is going on and are trying to manage it.”

What they know is that when COVID-19 patients show symptoms of infection, many organs fail to function properly. And when one organ fails, other organs may follow.

In addition, it disrupts the power of inflammation that emanates in people with severe COVID-19. As a result, it can damage the entire body, breaking open plaque and blood clots from the blood vessel wall, causing stroke, heart attack, and venous embolism.

Kulmholtz, who organized a meeting of cardiologists this week to discuss COVID-19, said the infection could damage the heart and the sac that surrounds it. Some patients develop heart failure and / or arrhythmias during the acute phase of the disease.

Heart failure debilitates organs, but drug therapy and lifestyle changes can regain much of its strength. Nevertheless, the original COVID-19 patient may become a lifelong patient with heart disease.

Making this picture cloudy is another potential after-effect: a blood disorder that predisposes to the formation of thrombus of any kind.