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Coronavirus damages the lungs in severe cases, as well as the heart and kidneys

Preliminary data suggests COVID-19 ICU patients are suffering from multiple organ damage.

Tibi Puiu
April 16, 2020 @ 10:03 pm

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 This image shows a CT scan from a man with COVID-19. Pneumonia caused by the new severe acute respiratory coronavirus 2 can show up as distinctive hazy patches on the outer edges of the lungs, indicated by arrows. 

The new coronavirus causes COVID-19, a respiratory disease that in the most severe cases attacks the lungs, destroying cells and potentially triggering death. Every day we learn new things about the coronavirus, and most of them aren’t pretty. The latest reports suggest that it’s not just the lungs that are attacked, other organs like the kidneys and heart are also severely affected, with potentially life-threatening consequences.

When the virus infects lung cells, it starts replicating. But our immune system doesn’t just wait by idly. It knows that the body is under attack by a foreign invader and, in response, it starts mobilizing the troops — a swarm of antibodies. However, these immune cells don’t just kill infected cells, they can also attack healthy cells, triggering inflammation.

As a result, air sacs in the lungs become swollen and filled with fluid — essentially the patient now has pneumonia and experiences breathing difficulties.

These symptoms also make it challenging for the lungs to pump oxygen in the blood, which can trigger a cascade of problems. Less oxygen naturally triggers more inflammation. All types of tissue, especially organs, require oxygen to function properly. So, with limited oxygen supply, other organs start to fail.

According to Alan Kliger, a nephrologist at Yale School of Medicine, about half of the COVID-19 patients who were hospitalized had blood or protein in their urine, which is a telltale sign of kidney damage.

Speaking to the Washington Post, Kliger added that preliminary data shows that 14% to 30% of intensive-care patients in New York and Wuhan, China, lost kidney function and required dialysis. In China, autopsies on deceased COVID-19 patients found that nine out of 26 had acute kidney injuries.

“That’s a huge number of people who have this problem. That’s new to me,” Kliger said. “I think it’s very possible that the virus attaches to the kidney cells and attacks them.”

There’s also evidence that the virus also attacks the heart. Physicians in both New York and China have reported a similar incidence of myocarditis and irregular heart rhythms that can lead to cardiac arrest in COVID-19 patients. According to a review of ICU cases from China, 40% of patients suffered arrhythmias and 20% had some form of cardiac injury.

Although much rarer, there are reports of liver damage due to COVID-19. There’s one such case in Long Island and five in China, but the small sample size is not enough to draw definite conclusions.

What’s particularly worrisome is the danger of blood clots in the veins of legs and other blood vessels. A study published last week monitored 81 patients with COVID-19 pneumonia in a Wuhan hospital, finding that 20 patients had blood clots that traveled to the lungs. lungs. Blood clots in the lungs are particularly dangerous because they can potentially trigger a fatal pulmonary embolism. Eight of the patients died as a result.

In New York, doctors are already treating ICU patients with blood thinners to counter the viral-triggered blood clots.

This kind of damage might be due to a cytokine storm — the overreaction of the body’s immune system that can cause complications and multiple organ failure. Cytokines are small proteins released by many different cells in the body, including those of the immune system where they coordinate the body’s response against infection and trigger inflammation.

Researchers hope to get to the bottom of things by investigating other possible causes of organ and tissue damage. Other causes include respiratory distress, medication, high fever, and the stress of intensive care unit hospitalization.

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