In the early days of the COVID-19 pandemic, the disease was characterized by many as a flu-like respiratory infection mainly affecting the lungs. Now, physicians recognize that the coronavirus can impact organs throughout the body. In a collaboration among physicians at Beth Israel Deaconess Medical Center (BIDMC) and Columbia University Irving Medical Center, researcher-clinicians have conducted an extensive review of the latest findings on COVID-19's effect on organ systems outside the lungs. Their review, published in Nature Medicine , also summarized proposed mechanisms behind these wide-ranging systemic effects and provided clinical guidance for physicians.
Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks biological mechanisms of the human body that are normally protective. We hope that our review will be a comprehensive resource for physicians, nurses and other health care workers caring for patients with COVID-19, and provide impetus to consideration of all organ systems involved while developing research priorities and therapeutic strategies." Kartik Sehgal, MD, co-lead author, hematology/oncology fellow in the Cancer Center at BIDMC
Based on their own experiences caring for patients with COVID-19 as well as recent reports in the scientific literature, the team of clinicians -- co-led by Columbia cardiology fellows Aakriti Gupta, MD and Mahesh V. Madhavan, MD, and senior author Donald Landry, MD, PhD, chair of medicine at the Columbia University Irving Medical Center -- delineate the myriad fronts on which the coronavirus may attack the body.
Beyond the severe respiratory distress now associated with severe COVID-19, the virus also may increase patients' risk of heart attack, kidney failure and clotting disorders, the physicians report. Neurological symptoms, including headache, dizziness, fatigue, and loss of smell, may occur in about a third of patients. Patients with severe cases of COVID-19 are also at risk for strokes caused by blood clots and delirium. "Physicians need to think of COVID-19 as a multisystem disease," said Gupta. "There's a lot of news about clotting but it's also important to understand that a substantial proportion of these patients suffer kidney, heart, and brain damage." Related Stories
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