First review of COVID-19 effects beyond the lungs

Pharmacy Times – July 22, 2020

Kartik Sehgal, MD (Hematology-Oncology, BIDMC) co-led a report published in Nature Medicine that chronicled the many ways that COVID-19 goes beyond the lungs to affect the heart, brain, kidneys and endocrine system. The extrapulmonary manifestations of COVID-19 are incredibly varied, researchers say, with the heart and kidneys particularly vulnerable to damage.

Physicians and researchers at the Beth Israel Deaconess Medical Center (BIDMC) and Columbia University Irving Medical Center have conducted an extensive review on the latest findings of how coronavirus disease 2019 (COVID-19) affects organ systems outside the lungs. The review also summarized proposed mechanisms behind these wide-ranging systemic effects and provided clinical guidance for physicians, according to a press release.

“Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks biological mechanisms of the human body that are normally protective,” said co-lead author Kartik Sehgal, MD, a hematology/oncology fellow in the Cancer Center at BIDMC, in a press release. “We hope that our review will be a comprehensive resource for physicians, nurses and other health care workers caring for patients with COVID-19, and provide impetus to consideration of all organ systems involved while developing research priorities and therapeutic strategies.”

Other than the severe respiratory distress associated with severe COVID-19, the virus also may increase patients’ risk of heart attack, kidney failure, and clotting disorders, according to the study authors. Neurological symptoms, including headache, dizziness, fatigue, and loss of smell may occur in approximately one-third of patients.

Further, patients with severe cases of COVID-19 are at risk for strokes caused by blood clots and delirium. “Physicians need to think of COVID-19 as a multisystem disease,” said Aakriti Gupta, MD, in a press release. “There’s a lot of news about clotting but it’s also important to understand that a substantial proportion of these patients suffer kidney, heart, and brain damage.”

According to the study authors, the researchers suspect that the complications may stem from the systemic inflammation that can occur as the immune system attempts to fight off the virus’ attack on the body, especially cells that line the blood vessels. These blood clots can travel all over the body and wreak havoc on organs, which can contribute to the widespread effects, according to the study authors.

Future studies following patients who experience complications during hospitalizations for COVID-19 will be crucial, according to the study authors.