This archive report was first published on 11 July 2020.
Coronavirus: A Multisystem Disease ¶
Published on July 11, 2020, a review of reports about Covid-19 patients by doctors at Columbia University Irving Medical Center in New York City revealed that the coronavirus damages not only the lungs but also the kidneys, liver, heart, brain, and nervous system.
The team's comprehensive picture shows that the coronavirus attacks virtually every major system in the human body, directly damaging organs and causing the blood to clot, the heart to lose its healthy rhythm, the kidneys to shed blood and protein, and the skin to erupt in rashes.
“Physicians need to think of COVID-19 as a multisystem disease,” said Dr. Aakriti Gupta, a cardiology fellow at Columbia who worked on the review. “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, and physicians need to treat those conditions along with the respiratory disease.”
The researchers found that the virus's affinity for a receptor called ACE2, which is found on cells lining the blood vessels, kidneys, liver ducts, pancreas, intestinal tract, and respiratory tract, contributes to the damage.
“These findings suggest that multiple-organ injury may occur at least in part due to direct viral tissue damage,” the team wrote.
Coronavirus infection also activates the immune system, leading to the production of inflammatory proteins called cytokines, which can damage cells and organs and contribute to severe symptoms.
“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,” Dr. Mahesh Madhavan, another cardiology fellow who worked on the review, said.
The researchers emphasized that doctors need to treat all of the effects of the virus when patients show up in the hospital, including blood clotting, kidney damage, heart damage, brain damage, and skin effects.
However, there is some good news: gastrointestinal symptoms may be associated with a longer duration of illness but have not been associated with increased mortality, and many of the skin effects, such as rashes and purplish, swollen “Covid toes,” clear up on their own.
