Your
Body Temperature
The majority of COVID-19
patients report a rise in their body temperature—aka a fever—which is your
body's response to fighting off an infection. "These can be full blown
102+ fevers for days to weeks or just 'low grade' fevers (which don't actually
qualify as a medical definition fever) in the 99's and low 100s," Brandon
Lawrence, MD, an emergency room physician at Abrazo Arrowhead Hospital in
Glendale, AZ, explains to Eat This, Not That! Health.
To
Your Body Itself—Aches and Pains
Oftentimes, fevers are also
accompanied by body/muscle aches. "The interesting thing I've been
seeing/reading here is that, unlike with the flu where body aches are
predominant, body aches here can actually be a predictor for a more severe
disease," points out Dr. Lawrence. "Obviously not everyone with body
aches has a severe form, but you're somewhat more likely if you
do"—including headaches, which are on the CDC's list of symptoms.
To
Your Nose
Some COVID-19 patients have
reported losing their sense of smell. "Probably the most fascinating part
of this to me is the loss of sense of smell and sometimes taste," explains
Dr. Lawrence. "It's often one of the first questions I've been asking
patients for the past month."
If you don't have the
symptom, it doesn't mean you do not have the virus, but if you have it,
"it's a pretty sensitive finding," he explains. "There's almost
never congestion or rhinorrhea (runny nose) associated with this. On brain MRIs
we have seen obstruction of olfactory clefts and, last I checked we are unsure
what is causing this blockage," he adds. Some scientists are speculating
that the virus may travel up through the nose's nerve endings, damaging cells.
To
Your Eyes
Another strange way COVID-19
can impact your body is via your eyes, as there have been several reports of
coronavirus-related conjunctivitis, aka pink eye. "Several reports suggest
that SARS-CoV-2 can cause a mild follicular conjunctivitis otherwise
indistinguishable from other viral causes, and possibly be transmitted by
aerosol contact with conjunctiva," the American Academy of Ophthalmology
recently said in a statement. The condition, which is an inflammation of
the membrane that lines the front of the eye and inner eyelid, is more commonly
reported in severe cases of the virus
To
Your Lungs
The lungs are considered
ground zero of COVID-19 damage, and are "probably the most important and
dramatic system affected by COVID 19," says Dr. Lawrence. "Some
people I've seen are largely unaffected here, while some are sitting
comfortably with dramatically reduced oxygen levels. Then there's those either
in respiratory distress or totally decompensated from the hypoxia that require
high flow oxygen or intubation."
There's a lot of debate
surrounding the cause of this, he explains. Many point to the 'cytokine storm,'
which is basically a body's almost overreaction to the disease process's
inflammatory phases. There was also the original theory that this was inducing
as ARDS (acute respiratory distress syndrome) which essentially causes lungs to
fail requiring different ventilation strategies and proning. "At this point,
we are fairly sure it doesn't cause a true ARDS syndrome even if the imaging
and hypoxia appear similar," he says.
"A further finding we
are seeing is that it is a 'prothrombotic state'—meaning that it has a
proclivity to induce blood clots. In this case, the blood clots travel to the
lungs, further damaging them. This isn't a completely validated theory, but it
is what I am frequently reading from critical care docs around the
country."
To
Your Kidneys
In severe cases of COVID-19,
"those that are having a prolonged course in the ICU," renal failure
requiring dialysis has been reported. "Again, this seems to be a part of
the cytokine storm problem," explains Dr. Lawrence.
To
Your Liver
In more severe cases of the
virus, elevated liver enzymes are also being reported. An AST, aspartate
aminotransferase test, is a liver blood test. The higher the level of AST
signifies a greater amount of liver damage. "We are seeing an elevated AST
linked with more severe disease," Dr. Lawrence explains
To
Your Blood
As Dr. Lawrence previously
explained in regards to the lungs, the "prothrombosis" occurs within
the blood vessels. "Another finding we are seeing is the clot load can be
so severe, that it actually causes poor blood flow in the legs and a handful of
the severe illnesses have resulted in amputations of limbs—like with Broadway
star Nick Cordero."
One theory Dr. Lawrence finds
interesting is that the virus actually binds to something within the hemoglobin
structure—part of what makes up the red blood cells, which carries and delivers
oxygen to the vital organs. "This causes an almost carbon monoxide/high
altitude sickness sort of picture where oxygen is actually displaced from the
red blood cells, decreasing your overall ability to carry oxygen resulting in
the profound hypoxia. The two of these syndromes together creates many
challenges for providers," he explains.
To
Your Heart
In regards to the heart
organ, in many cases of COVID, there is a mildly elevated BNP —which in very
layman's terms means a relative fluid overload in relation to how well the
heart is pumping—"so in people with congestive heart failure it is often
dramatically elevated," Dr. Lawrence explains. "We are seeing
patients come away with reduced ejection fraction (heart pumping ability) in
severe disease and sometimes a picture of a viral cardiomyopathy (dilated
heart)." While it isn't clear what the outcome is, in normal
viruses, "patients can often recover from this," he adds
To
Your Toes
One strange manifestation of
COVID-19 has been dubbed "COVID toes," a "strange new
symptom" that is often seen in otherwise asymptomatic kids (or just with
fever), explains Dr. Lawrence. However, these red spots, "sometimes
painful on the feet/toes," have not been seen to be associated with severe
illness and usually resolve without any treatment in 2-3 weeks.
To
Your Brain
Patient's often present to
the ED or primary clinic "altered" meaning they are not at their
normal mentation baseline. "Many of these that I have seen are often
hypoxic, but not all," Dr. Lawrence explains. "We are unsure what the
etiology here is of the altered mental status (probably our friend the cytokine
storm)." Additionally, with the prothrombotic state, he adds that they are
also seeing strokes unfortunately.
To
Your Gut
Multiple studies, including
out of China, suggest that over half of patients with known infection have been
shown by polymerase chain reaction (PCR) to have virus RNA in their stool,
explains Amir Masoud, MD, a Yale Medicine gastroenterologist and assistant
professor of internal medicine (digestive diseases) at Yale School of Medicine.
"In fact, almost a quarter of patients with virus RNA in their stool had
negative respiratory samples," he explains. "It's not yet clear if
this represents infectious virus or just fragments without infection
capability."
Viral RNA has also
been found in biopsies taken from various segments of the GI tract which may
suggest replication in those tissues. "We are also learning more about the
GI symptoms that can manifest with COVID infection, the most common by far
being diarrhea, which was reported in almost a fifth of infections," he
adds. Nausea and vomiting can also occur and GI symptoms may be present
irrespective of respiratory complaints, "though the latter is thought to
represent the mortality risk associated with this virus."