Saturday, July 11, 2020

Nature Med. Review: Extrapulmonary manifestations of COVID-19


Over the past 5 months I've highlighted literally dozens of scientific papers and reports that attest to the extraordinary systemic, extrapulmonary impact of COVID-19 on the human host. While ARDS and pneumonia are often associated with severe SARS-CoV-2 infection, other organs - including the brain, heart, and kidneys - are often involved as well.

A few examples include:

COVID-19: Another Neurological Study To Ponder

JAMA Neurology: Elevated Risk of Ischemic Stroke With COVID-19

PrePrint: Cytokine Release Syndrome-Associated Encephalopathy in Patients with COVID-19

CDC HAN: Multisystem Inflammatory Syndrome In Children (MIS-C)

EID Journal: Two Reports On Thrombotic Events In COVID-19 Patients

EID Journal: Pulmonary Embolism and Increased Levels of d-Dimer in COVID-19 Patients

EID Journal: Relative Bradycardia In Mild To Moderate COVID-19 Cases, Japan

We've also seen anecdotal reports of huge increases in out-of-hospital cardiac arrests in places (NYC, Houston, etc.) where the pandemic was raging (see NBC affiliate Massive Spike in NYC ‘Cardiac Arrest’ Deaths Seen as Sign of COVID-19 Undercounting), as well as studies suggesting that COVID-19 has claimed far more lives than have been officially counted (see Netherlands RIVM: COVID-19 Incidence, Mortality & Immunity). 

Most of these reports and studies have concentrated on one main system (respiratory, circulatory, CNS, etc.) or organ,  providing us with isolated pieces of the puzzle.  But today we have a major review - published in Nature Medicine - that brings all of those pieces together to provide a more complete picture of COVID-19 disease. 

The graphic at the top of this blog - tweeted overnight by one of the study's authors - shows just how diverse COVID-19 impacts can be on the human host. 

This is a detailed, lengthy review, primarily of interest to clinicians.  You can read the full report at the following link:

Gupta, A., Madhavan, M.V., Sehgal, K. et al. Extrapulmonary manifestations of COVID-19. Nat Med (2020).

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Received 29 April 2020
Accepted 05 June 2020
Published 10 July 2020

Barely six months into this pandemic, we are still learning about both the acute and chronic aspects of SARS-COV-2 infection. Anecdotal reports suggest a significant number of COVID-19 survivors continue to report one or more (often) debilitating symptom weeks or even months post-infection. 

A story recently published by the American Heart Association News, reports:
Months after infection, many COVID-19 patients can't shake illness

By American Heart Association News

A similar report was published this past week by STAT News.
My Covid-19 symptoms have lasted more than 100 days, and I’m not alone. Will they ever end?


JULY 8, 2020
While many people continue to regard COVID-19 as a mild-to-moderate `flu-like' illness in most people, and take comfort from the notion that only 1% or 2% (of mostly elderly cases) appear to die from the infection, it may be years before we can fully tally the number of deaths, and gauge the long-term burden of disability, brought on by this pandemic.