PHN Explores: Inflamed brains, toe rashes, strokes: Why COVID-19’s weirdest symptoms are only emerging now (From National Geographic)

PHN Content By Mat Edelson

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If We Had Written the Headline

Why the coronavirus seems to have more symptoms than the warnings on a drug label

Why You Should Care

If you feel like coronavirus is turning you into a hypochondriac, you’re not alone (“Honey, are my toes purple?”). It makes sense; not a day seems to go by without some new and often scary symptom being linked to Covid-19. But before we go running to the ER, let’s take a look at the evolving facts, ok? They might even make you feel a little better (or at least less worried).

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What's New(s)

It might help if we start with what the CDC says are recognized common symptoms of a coronavirus infection. These include:

  • Cough;
  • Shortness of breath or difficulty breathing;
  • Fever;
  • Chills;
  • Muscle pain;
  • Sore throat, and;
  • New loss of taste or smell.

The CDC also adds some less-common symptoms, including nausea, vomiting and diarrhea.

However, as National Geographic reporter Amy McKeever points out in her story, “Every human body is unique, so a disease that strikes millions of people will yield some oddities.”

Those oddities are enough to fill a textbook, or at least hundreds of medical journals. According to a story in the Washington Post (see ‘Bonus Biscuit,’ below), the World Health Organization lists 14,600 Covid-19 research studies. That’s a whole lot of brainpower trying to suss out why, in small subsets of cases, people infected with coronavirus exhibited symptoms including:

  • blood clots
  • kidney, lung, or heart damage;
  • body rashes;
  • pinkeye;
  • brain inflammation;
  • strokes;
  • chest pain (including heart attack), and;
  • red lesions on toes.

That’s a frightening list, made moreso because these symptoms sometimes occur in otherwise healthy and young people. But again, some context can lend perspective. As the Nat Geo story notes, most people who get a symptomatic case of Covid-19 experience it as a respiratory disease, ranging anywhere from something flu-like to pneumonia requiring hospitalization.

So what’s causing these rarer cases? Researchers are focusing in on three factors: In some people, their immune system overreacts to a coronavirus invasion. In med-talk this is called a cytokine storm; when it happens, the immune system can’t tell the virus from healthy cells and starts destroying everything; the bad, the good, and in the worst cases, major organs.

These cytokine storms may or may not be related to another major problem, which is blood related. Blood vessel inflammation, blood stagnation, and blood clots may all be part of the Covid-19 circle of damage, which could account for the uptick in strokes and dangerous clots that lodge in different parts of the body (notably the kidneys, lungs, and heart).

Finally, it’s possible that the virus is directly attacking other organs besides the lungs. This has a lot to do with the types of receptors on certain cells that the virus  ‘tricks’ into laying out the welcome mat. They’re called ACE2 receptors and are found on lung, heart, and kidney cells (See ‘Deep Dive,’ below)

Yeah, we know, it’s at this point that you want to put your head in your hands and say “OMG” (or perhaps something stronger). So here’s a few things that we offer as a takeaway from this issue.

First, it’s not clear yet if these rare symptoms are directly related to Covid-19, or if they happened to occur at the same time as a coronavirus infection. It could be like having a stomach ache and a migraine simultaneously. Did one cause the other? Or was it just a medical coincidence? It often takes scientists a long time to figure this out, and most of these odd cases have been observed in just the last few months.

Secondly, even these uncommon cases are often very treatable, with medications such as blood thinners (aka anticoagulants). And over time, researchers will figure out both the best treatments and which people are at greater risk for coming in with an unusual case of Covid-19.

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Story Source

National Geographic, May 21, 2020, by Amy McKeever. See the story

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Story Expert

Robert Bonow, professor of cardiology, Northwestern University Feinberg School of Medicine; past president, American Heart Association.

Bonus Biscuit

There’s an excellent animated video that the Washington Post put together which explains how coronavirus invades the body. It throws the science at you pretty quickly (in fact we had to watch it twice at one point in the video, just to make sure we understood everything), but we really appreciated the Post’s efforts, along with the accompanying reporting: Doctors keep discovering new ways the coronavirus attacks the body. (See the story)

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Deep Dive

Here’s an excellent piece on ACE2 receptors and the role they’ve played in both the current and past coronavirus outbreaks. From STAT, a Boston Globe Media science and health news website: The coronavirus sneaks into cells through a key receptor. Could targeting it lead to a treatment? (See the story)