SARS-CoV-2 infection or severe acute respiratory syndrome implies that the disease involves the lungs and presents mainly as pneumonia or difficulty in breathing.
Studies have shown that Covid-19 may directly or indirectly affect the heart and cause heart injury. This occurs even in persons with or without preexisting heart disease. Damage to the muscles of the heart called myocardial injury, acute coronary syndrome, inflammation of the heart, or arrhythmias could occur.
The possible causes are stress, hypoxia or the low levels of oxygen, damage to the small vessels of the heart, and the systemic inflammatory response (cytokine storm) brought about by the virus. The exact cause in each patient is often not fully identified.
Among some patients clinically suspected of having myocardial injury or stress cardiomyopathy, there was significant recovery of the major pumping portion of the heart – the left ventricle –in a few days. Yet in severe cases, complications included heart failure, very low blood pressure or shock, or markedly elevated blood pressure (hypertensive crisis).
Researchers have also shown that in patients who have severe Covid-19 infection, the kidneys could also be harmed. This injury is seen even among patients whose kidneys were previously healthy. The U.S. and U.K. reported that acute kidney injury occurs in 17 to 43 percent of reports, 30 percent of hospitalized patients had moderate or severe kidney disease, and some patients needed dialysis.
The coronavirus can infect the cells and directly cause cellular damage. It may also cause disease because of the inflammatory reaction. Thrombosis or blood clots form inside the blood vessels of the kidneys and interrupt the kidneys’ functions. Recovery of function may occur, and outcomes are better among those who did not need dialysis. As in heart injury, hypertension, obesity, diabetes mellitus predisposes to more severe disease.
Other major organs are not spared: the liver and the brain. At increased risk of developing poorer outcomes are those with preexisting hypertension, heart disease, obesity, and diabetes mellitus.
Because of these and other complications of Covid-19, medical costs are high. Laboratory tests like troponin test for heart injury, electrocardiograms or EKG, echocardiography, blood tests, and other diagnostic tests are done to assess the patient. Add to these the medications, hospital accommodation,and personal protective equipment.
Dexamethasone is the drug proven to improve death rates but it is used only among critically ill patients. It is not to be taken orally to prevent infection or Covid complications. Remdesivir can prevent severe Covid-19 among hospitalized patients but it does not improve mortality rates. It is also costly and not easily available.
Patients recover within two to six weeks after Covid-19 infection. Studies show that in some patients, there may be residual or lasting symptoms. Rehabilitation may be needed, and preexisting disease may worsen. Some patients develop psychiatric and other complications.
Prevention is still the best cure. The best approach is still to just follow guidelines given by the government, the World Health Organization, Department of Health, your family physician, and trusted authorities. The basic ones are free: stay at home, maintain physical distancing, eat well, and rest well.
April 24, 2024
