U.S. still face medical challenges of COVID-19 sequelaes even infection down

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U.S. still face medical challenges of COVID-19 sequelaes even infection down

U.S. still face medical challenges of COVID-19 sequelaes even infection down.  According to the New York Times Epidemic Tracker, on May 28, 2021, there were 21,727 new COVID-19 cases in the United States, close to the lowest level in the past year; compared with the peak of 300,628 cases on January 8, a decrease of 93%. 

However, Nature magazine published a review article “Count the cost of disability caused by COVID-19” on May 26, 2021, with the subtitle: Focusing only on cases and deaths hides the pandemic’s lasting health burden on people, societies and economies. “

Behind the control of the epidemic in the United States are not only 594,000 people who have passed away, but also 33.24 million infected people.

The neglected sequelae of COVID-19

For many people, COVID-19 has become a set of numbers that fluctuate daily. People are happy to see the decrease in the number of cases and the decrease in the number of new deaths.

But for many COVID-19 survivors, surviving the new coronavirus infection and being discharged from the hospital is just another long-term treatment and the beginning of a difficult life. Because of sequelae.

Correspondingly, at present, there are only few and incomplete data on the disability status of COVID-19 patients. This shows a serious neglect of the sequelae of COVID-19.

(Image source: Nauture Magazine)

High proportion of sequelae

The COVID-19 sequelae follow-up study published in Lancet on January 8, 2021 showed that 76% of discharged patients had at least one sequelae 6 months after the onset of onset, the most common being fatigue (63%), followed by sleep disorders ( 26%), anxiety and depression and other psycho-neurological symptoms (23%), 13% of patients had abnormal renal function.
See: Cao Bin et al. published an article in The Lancet summarizing the 6-month follow-up results of Chinese COVID-19 patients. 76% had at least one sequelae, and antibody levels dropped by 52.5%.

Extensive organ damage

In fact, the new coronavirus can not only cause serious damage to the lungs, but also affect other tissues and organs.

The article “How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes” published in Science magazine discussed how the new coronavirus attacks the main organs of the human body.

Science: The new coronavirus attacks the main organs of the human body

(Image source: Science Magazine)

Coronavirus attacks the heart and affects blood clotting function

The JAMA Cardiology magazine published the results of a study of 416 patients with COVID-19 pneumonia in Wuhan, China on March 25, 2020, showing that 20% of the patients had heart damage. In another study of 138 patients in Wuhan, 44% of patients had arrhythmia.

In addition, studies have shown that COVID-19 patients may have abnormal coagulation function. In the study of 184 ICU hospitalized COVID-19 patients in the Netherlands published in Thrombosis Research on April 10, 2020, 38% of patients had abnormal coagulation function and plaques. After falling off, it may cause pulmonary embolism or stroke.

New coronavirus causes kidney damage

The new coronavirus enters body tissues by binding to ACE2 receptors on human cells. Because kidney cells also highly express ACE2 receptors, they have become another important target of the virus.
According to a preprinted research report, 27% of 85 hospitalized patients in Wuhan suffer from renal failure. Another study showed that among nearly 200 hospitalized COVID-19 patients in Wuhan and its vicinity, 59% of the urine contained protein and blood, indicating kidney damage.

Coronavirus affects the brain

Another striking set of symptoms of COVID-19 patients is concentrated in the brain and central nervous system. Dr. Frontera said that 5% to 10% of COVID-19 patients in her hospital have neurological symptoms that require evaluation by a neurologist. “May underestimate the proportion of brain damage in COVID-19 patients”, especially because many patients use sedatives and use ventilators.

In addition to encephalitis, seizures, and “sympathetic nerve storm”, there are patients with strokes, and many people report loss of smell.

Robert Stevens, an intensive care doctor at Johns Hopkins Medicine, said that ACE2 receptors exist in the neurocortex and brainstem, which may be the pathophysiological basis of the new coronavirus invading the brain.

Other organs

In addition to the above-mentioned key tissues and organs, the intestines and liver are also damaged. It is often used to treat the damage caused by medication or over-stressed immune system. More COVID-19 survivors have reported abnormal blood sugar.

(Patients undergoing dialysis. COVID-19 leaves survivors with long-lasting organ damage, including kidneys. Credit: Grant Hindsley/New York Times/Redux/eyevine)

Persistent immune disorders

On May 19, 2021, Nature published an important article from Yale University, reporting another newly discovered immune pathological mechanism of COVID-19-the production of autoantibodies. After infection, it may cause more permanent immune disorders, and immune disorders, inflammation and autoimmunity may be the key reasons for exacerbating the disease and producing sequelae.

The analysis showed that compared with healthy controls, COVID-19 patients produced a large number of autoantibodies against immune-related proteins, including cytokines, chemokines, complement and immune cell surface proteins.

Further studies have found that these autoantibodies can inhibit the antiviral function of the immune system and disrupt the immune function by interfering with the immune cell signal pathway and the distribution of immune cells.

In addition, some COVID-19 patients will also produce antibodies against their own tissue antigens, and some antibodies are related to disease progression and long-lasting sequelae.

(source:internet, reference only)

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