COVID-19 is the name of the illness caused by a virus known as SARS-CoV-2, one of a group of respiratory viruses known collectively as coronaviruses because of the crown-like protrusions on the spherical surface of this microbe.
Since making its appearance in Wuhan province, China late in 2019, the COVID-19 global pandemic has required the medical community to learn a great deal and rapidly about this serious infection.
Early signs and symptoms are not very remarkable – fever, muscle aches and fatigue are common. So is sore throat and cough. Diarrheal illness is seen from time to time.
We know that many individuals, maybe 10-20%, have no symptoms. This is good for those individuals, of course, but it also means that this virus is spread a great deal by individuals who don’t know they are contagious. As most people know, progressive respiratory symptoms, especially shortness of breath, are potentially serious and may signal the need for extra oxygen delivered in a hospital, and for some people, the need for a respirator. Unlike other lung infections, the respiratory course of COVID-19 tends to be protracted. In our experience at Northwell, and nationally, individuals who need a ventilator may be in the ICU on life support for 2 weeks or longer.
The novel coronavirus also seems to attack several other body systems. According to our experience across Northwell Health, 19% of patients sick enough to be hospitalized develop “acute kidney injury” or AKI. Many of these people will need at least short-term dialysis. Early experience is that people who have kidney injury from COVID-19 have a poor prognosis, with 70% expiring.
Less common but even more serious are complications that happen when this virus attacks the heart. Viral infection of the heart muscle is called viral myocarditis. When this happens, the heart may stop pumping as effectively as it usually does. Additionally, abnormal rhythms can occur, and some of these may lead to sudden death.
Other organs are affected as well. Liver function may be abnormal. The blood clotting system may react to create blockages to blood vessels, including those in the lungs. Finally, sufferers can experience a range of neurological complications from loss of the sense of smell, to the inflammation of the brain known as encephalitis.
Despite interest in a range of potential therapies, very little other than meticulous attention to supportive care is known to help. At Northwell, we are participating in a number of research studies aimed at better understanding the infection and strategies to prevent and mitigate its effects. For now, prevention is the best bet – social distancing, masks and hand hygiene save lives.
Dr. Michael Grosso is medical director of Huntington Hospital