Besides the respiratory issues that leave patients gasping for
breath, the virus that causes COVID-19 attacks many organ systems,
in some cases causing catastrophic damage.
"We thought this was only a respiratory virus. Turns out, it goes
after the pancreas. It goes after the heart. It goes after the
liver, the brain, the kidney and other organs. We didn't appreciate
that in the beginning," said Dr. Eric Topol, a cardiologist and
director of the Scripps Research Translational Institute in La
Jolla, California.
In addition to respiratory distress, patients with COVID-19 can
experience blood clotting disorders that can lead to strokes, and
extreme inflammation that attacks multiple organ systems. The virus
can also cause neurological complications that range from headache,
dizziness and loss of taste or smell to seizures and confusion.
And recovery can be slow, incomplete and costly, with a huge impact
on quality of life.
The broad and diverse manifestations of COVID-19 are somewhat
unique, said Dr. Sadiya Khan, a cardiologist at Northwestern
Medicine in Chicago.
With influenza, people with underlying heart conditions are also at
higher risk of complications, Khan said. What is surprising about
this virus is the extent of the complications occurring outside the
lungs.
Khan believes there will be a huge healthcare expenditure and burden
for individuals who have survived COVID-19.
LENGTHY REHAB FOR MANY
Patients who were in the intensive care unit or on a ventilator for
weeks will need to spend extensive time in rehab to regain mobility
and strength.
"It can take up to seven days for every one day that you're
hospitalized to recover that type of strength," Khan said. "It's
harder the older you are, and you may never get back to the same
level of function."
While much of the focus has been on the minority of patients who
experience severe disease, doctors increasingly are looking to the
needs of patients who were not sick enough to require
hospitalization, but are still suffering months after first becoming
infected.
Studies are just getting underway to understand the long-term
effects of infection, Jay Butler, deputy director of infectious
diseases at the U.S. Centers for Disease Control and Prevention,
told reporters in a telephone briefing on Thursday.
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"We hear anecdotal reports of people who have persistent fatigue, shortness of
breath," Butler said. "How long that will last is hard to say."
While coronavirus symptoms typically resolve in two or three weeks, an estimated
1 in 10 experience prolonged symptoms, Dr. Helen Salisbury of the University of
Oxford wrote in the British Medical Journal on Tuesday.
Salisbury said many of her patients have normal chest X-rays and no sign of
inflammation, but they are still not back to normal.
"If you previously ran 5k three times a week and now feel breathless after a
single flight of stairs, or if you cough incessantly and are too exhausted to
return to work, then the fear that you may never regain your previous health is
very real," she wrote.
Dr. Igor Koralnik, chief of neuro-infectious diseases at Northwestern Medicine,
reviewed current scientific literature and found about half of patients
hospitalized with COVID-19 had neurological complications, such as dizziness,
decreased alertness, difficulty concentrating, disorders of smell and taste,
seizures, strokes, weakness and muscle pain.
Koralnik, whose findings were published in the Annals of Neurology, has started
an outpatient clinic for COVID-19 patients to study whether these neurological
problems are temporary or permanent.
Khan sees parallels with HIV, the virus that causes AIDS. Much of the early
focus was on deaths.
"In recent years, we've been very focused on the cardiovascular complications of
HIV survivorship," Khan said.
(This story corrects spelling of doctor's name to Khan instead of Kahn in last
two paragraphs)
(Reporting by Julie Steenhuysen; additional reporting by Caroline Humer and
Nancy Lapid in New York; Editing by Bill Berkrot)
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