As doctors and specialists continue to investigate the complexity of the coronavirus symptoms, ways it’s spread and the rate of transmission, the medical community is discovering that the virus can cause long-term effects in patients.
Doctors are seeing the novel coronavirus attaching to human cells in many different parts of the body and penetrate major organs such as the heart, kidneys and brain.
“As the time passes and we know more about it, considering it is novel and there is nothing in the books, we are learning as we go,” Dr. Navpreet Sidhu with North Colorado Medical Center (NCMC) explained. “We are seeing more and more reports about other systems being involved.”
Sidhu specializes in critical care and pulmonology at the medical center.
“We wanted to follow patients closely, from a specialist standpoint, knowing that it’s mainly lungs but there are other manifestations and systems being affected,” Sidhu explained. “Lung-wise we are seeing scarring and lung disease.”
Strokes, depression, shortness of breath, cardiac manifestations, blood clots, fatigue and seizures are some of the more common symptoms Sidhu is seeing in patients with residual effects from the virus.
“The body trying to fight the virus, but other things are happening that can hurt other organs and systems,” she said. “We need to educate people more and more and get the word out.”
NCMC has created a specialty post-COVID clinic to help track the virus and possible after-effects, said Sara Quale, Regional Marketing and Public Relations director. The clinic offers patients who have recovered from the virus a specific place where they can go with questions and get care if they start experiencing post-virus symptoms.
“This clinic is going to be a great help to identify the aftermath. That’s why we are doing this,” Sidhu said. “This will help us be proactive in caring for patients.”
The clinic offers access to a variety of specialists including cardiology and neurology physicians, she explained. The data collected can be shared with other medical professionals in the community and around the state.
At UCHealth, neurohospitalist Dr. Brian Kaiser has also seen patients who have experienced similar residual effects of the virus.
“I have seen three patients so far that had COVID and had neurological issues,” he said. “One of them had a stroke, the other one had encephalitis and the third one had seizures.”
Around 5% of patients with COVID are reported to have had strokes, Kaiser said. However, determining if the stroke was caused by the virus or by co-morbidities that put people at risk has been a challenge.
“It’s probably a combination of both things,” he said. “There seems to be some kind of pro-inflammatory state causing the blood to have a tendency to become thicker, leading to things like strokes.”
While Kaiser can’t say the strokes are specifically related to COVID, health care providers are looking at these types of issues “more aggressively.”
As far as neurological issues doctors are seeing, specialists are speculating that there may be a breakdown between the blood-brain barrier, allowing the virus to infect the brain.
“That is pretty rare,” Kaiser explained. “There is some evidence, especially with people with the lack of ability to smell, that the virus may actually travel along the olfactory nerve as a way to get into the brain.”
Medical journals are reporting that around 36.4% of patients who have contracted COVID-19 can have some kind of neurologic symptoms, Kaiser said.
Some of things people should be aware of in regard to possible residual effects are new weakness, sensation changes, dizziness, cramping or swelling in the legs, consistent headaches, balance problems and shortness of breath, Kaiser and Sidhu advised.
“Anything that changes from your baseline, I would encourage people to seek medical attention,” Kaiser suggested.
Unfortunately, doctors are learning that children and teens are also susceptible to the after effects of the virus.
Doctors’ offices in Britain, Spain, Italy and around the U.S. are seeing young patients experiencing a number of odd symptoms such as rashes, high fevers and heart inflammation.
Children’s Hospital Colorado has reported seeing a newly identified condition called pediatric multisystem inflammatory syndrome, MIS-C, in children.
“Much remains unknown about how exactly this develops, but it’s related to the body’s attempts to fight an invader,” Dr. Sam Dominguez said in a Denver Post interview.
Dominguez is a pediatric infectious disease specialist at the hospital.
In an interview with the Denver Post, Dr. Rachel Herlihy, Colorado’s state epidemiologist said that while MIS-C is rare, it can appear four weeks after a child has been infected with COVID-19. However, children often see very mild or no symptoms at all from the virus.
The Centers for Disease Control, CDC, lists the following symptoms of MIS-C:
- Fever lasting 24-hours or more, high levels of inflammation in lab tests and evidence of a COVID-19 infection.
- At least two of the following symptoms — rash, red eyes, puffiness of hands or feet, heart problems, trouble breathing, seeing confused or overly sleepy, or digestive problems like a stomach ache or vomiting.
Physicians are comparing MIS-C to Kawaski disease due to both being inflammatory conditions that are primarily seen in children.
Children seen at the hospital with MIS-C are being treated with immune globulin (IVIG) or other anti-inflammatory medications, the hospital’s website stated. Most of the patients the hospital has cared for have responded will to the treatments.
“We are seeing a lot of systems involved because this virus is effecting a lot of people,” Sidhu said. “And that’s why we are seeing a lot of different things. Different people are developing issues with different organs and we are seeing multi-organ failure. Who is going to get which organ hit, we don’t know.
“I haven’t seen anything like this before,” she added.
For more information on the coronavirus in adults and children, go to www.cdc.gov.
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