11:58 AM 7/12/2020 - 'A multisystem disease': How coronavirus affects the entire body

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Extrapulmonary manifestations of COVID-19 | Nature Medicine - 11:58 AM 7/12/2020
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Xiong Qi, Xinhua via AP, File

'A multisystem disease': How coronavirus affects the entire body

By Maggie Fox, CNN | Posted - Jul. 11, 2020 at 9:58 a.m.


52



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mikenov on Twitter: Extrapulmonary manifestations of COVID-19 | Nature Medicine nature.com/articles/s4159

Extrapulmonary manifestations of COVID-19 | Nature Medicine nature.com/articles/s4159



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Michael Novakhov - SharedNewsLinks: Researchers decode symptoms of COVID-19 outside lungs, call it a 'multisystem disease'

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Researchers decode symptoms of COVID-19 outside lungs, call it a 'multisystem disease'Researchers decode symptoms of COVID-19 outside lungs, call it a 'multisystem disease'  |  Photo Credit: iStock Images
Boston: Scientists, including those of Indian-origin, have provided the first extensive review of COVID-19's effects outside the lungs, and have recommended that physicians treat it as a multisystem disease with manifestations including blood clots, kidney failure, and neurological symptoms like delirium.
"I was on the front lines right from the beginning. I observed that patients were clotting a lot, they had high blood sugars even if they did not have diabetes, and many were experiencing injury to their hearts and kidneys," said Aakriti Gupta, a co-author of the study from Columbia University in the US.
According to the review of studies, published in the journal Nature Medicine, a substantial proportion of COVID-19 patients suffer kidney, heart, and brain damage.
The researchers recommended that doctors treat these conditions along with the respiratory disease.
"Physicians need to think of COVID-19 as a multisystem disease," Gupta said.
One of the non-respiratory complications most reported by studies is blood clotting, according to the researchers.
They said these clotting complications may stem from the virus' attack on cells that line the blood vessels.
The scientists explained that when the virus attacks blood vessel cells, inflammation increases, and blood begins to form clots, big and small.
These blood clots, according to the study, can travel all over the body and wreak havoc on organs, perpetuating a vicious cycle of inflammation.
"Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks the normally protective biological mechanisms. We hope that this would help in the development of more effective treatments for COVID-19 in the near future," said Kartik Sehgal, another co-author of the study from Harvard Medical School in the US.
According to the researchers, the formation of clots can lead to heart attacks.
However, they said the exact mechanism of heart damage in COVID-19 patients is currently unclear since the virus has not been frequently isolated from the heart tissue in autopsy cases.
The researchers believe the heart muscle may be damaged by systemic inflammation, and the accompanying release of immune system's signalling molecules, cytokines.
They said a flood of the cytokines which normally clear up infected cells can spiral out of control in severe COVID-19 cases.
Another surprising finding, according to the scientists, is the high proportion of COVID-19 patients in the ICU with acute kidney damage.
They said the ACE2 receptor molecule which is used by the virus to gain entry into human cells is found in high concentrations in the kidney, and could likely be responsible for the renal damage.
In New York City in the US, the scientists said, renal failure was reported in up to 50 per cent of patients in the ICU.
"About five to 10 per cent of patients needed dialysis. That's a very high number," Gupta said.
Describing the neurological symptoms of COVID-19, the researchers said these include headache, dizziness, fatigue, and loss of smell, which may occur in about a third of patients.
They said strokes caused by blood clots was observed in up to six per cent of severe cases, and delirium in eight to nine per cent of COVID-19 patients.
"COVID-19 patients can be intubated for two to three weeks: a quarter require ventilators for 30 or more days," Gupta said.
"This virus is unusual and it's hard not to take a step back and not be impressed by how many manifestations it has on the human body," said Mahesh Madhavan, another co-author of the study from Columbia University.


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SARS-CoV-2 is a strain of severe acute respiratory syndrome-related coronavirus (SARSr-CoV). It is believed to have zoonotic origins and has close genetic similarity to bat coronaviruses, suggesting it emerged from a bat-borne virus.
There is no evidence yet to link an intermediate animal reservoir, such as a pangolin, to its introduction to humans. The virus shows little genetic diversity, indicating that the spillover event introducing SARS-CoV-2 to humans is likely to have occurred in late 2019.


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President Trump: "Roger Stone was treated very badly." pic.twitter.com/WMTRlOpGWr

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White supremacist violence in the U.S. is on the rise, with a sharp increase in deadly incidents over the last five years. (From @NewsHour) pbs.org/newshour/show/

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(MENAFN) The global health body chief said on Friday, two World Health Organization (WHO) specialists are demanding China to cooperate with scientists there to study the spread of COVID-19 pandemic from animals to humans.
Addressing a webinar, the WHO Director-General Tedros Adhanom Ghebreyesus said the global health specialists will also make a scientific plan with their Chinese counterparts to find the zoonotic source of the coronavirus.
He said, "As we continue to tackle the pandemic, we are also looking into the origins of the virus".
Adhanom said the scientists want to learn about the development made in understanding the animal reservoir for coronavirus and how the virus jumped between animals and humans.
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#PopeFrancis says he thinks about #HagiaSophia and is "very saddened". The ancient Christian Basilica in Istanbul was recently transformed into a mosque.
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Michael Novakhov - SharedNewsLinks: At least 61 US Marines infected with COVID-19 at bases in Japans Okinawa

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TOKYO (AP) - The governor of Japans Okinawa island demanded a top U.S. military commander take tougher prevention measures and more transparency hours after officials were told that more than 60 Marines at two bases have been infected with the coronavirus over the past few days.
Okinawan officials on Sunday reported a total of 61 cases 38 of them at Marine Corps Air Station Futenma, which is at the center of a relocation dispute, and another 23 at Camp Hansen since July 7. They said that U.S. military officials told them the two bases have since been put in lockdown.
The disclosure of the exact figures came only after Okinawa's repeated requests to the U.S. military.
Gov. Denny Tamaki, in telephone talks late Saturday with Lt. Gen. H. Stacy Clardy, commander of III Marine Expeditionary Force, demanded the U.S military increase disease prevention measures to maximum levels, stop sending personnel from the mainland U.S. to Okinawa and seal the bases, as well as provide more transparency.
"Okinawans are shocked by what we were told (by the U.S. military)," Tamaki told a news conference Saturday. "It is extremely regrettable that the infections are rapidly spreading among U.S. personnel when we Okinawans are doing our utmost to contain the infections."
"We now have strong doubts that the U.S. military has taken adequate disease prevention measures," he added.
Tamaki said he wants more talks with the U.S. military. Okinawan officials also asked the Japanese government to pressure the U.S. side to provide details including the number of cases, seal off Futenma and Camp Hansen, and step up preventive measures.
Adding to their concern is quarantining of an unidentified number of American service members arriving from the mainland U.S. for ongoing staff rotations at an off-base hotel due to shortage of space on base, officials said.
The Marines said in a statement Friday that the troops were taking additional protective measures to limit the spread of the coronavirus and were restricting off-base activities. The statement said measures are "to protect our forces, our families, and the local community," without providing details on the infections.
The Marine Corps Installations Pacific said on its Facebook page on Saturday that "this week, the Marine Corps experienced two localized clusters of individuals who tested positive for the virus." It said those who tested positive were in isolation.
Okinawa is home to more than half of about 50,000 American troops based in Japan under a bilateral security pact, and the residents are sensitive to U.S. base-related problems. Many Okinawans have long complained about pollution, noise and crime.
Okinawans also oppose a planned relocation of Futenma Air Base from the current site in a densely populated area in the south to a less populated area on the east coast.
Okinawa has had about 150 cases of the coronavirus. In all, Japan has had about 21,000 cases and 1,000 deaths, with Tokyo reporting more than 200 new cases for a third straight day Saturday.
Copyright 2020 Associated Press. All rights reserved.


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