A breathless viral
Dr Y. Gopi Krishna, Senior Interventional Pulmonologist, Yashoda Hospitals, shares atypical symptoms of coronavirus infection
In one case, we witnessed a dangerous manifestation of the Guillain–Barre syndrome, in which the protecting muscles and nerves are suddenly affected, which leads to sudden respiratory arrest
— Dr Y Gopi Krishna, senior interventional pulmonologist, Yashoda Hospitals
SARS-COV-2 has caused significant illness and deaths around the world. While SARS-COV-2 is known to cause substantial pulmonary diseases such as pneumonia and acute respiratory distress syndrome (ARDS), clinicians have observed other presentations of this disease.
Dr Y Gopi Krishna, senior interventional pulmonologist, Yashoda Hospitals, tells us that scientists are now documenting a growing list of atypical coronavirus infection symptoms, thus providing doctors with more insight into the emerging disease. The new and surprising symptoms that have appeared include strokes, blood clotting, the rare Kawasaki disease, purple toe rashes and ‘silent hypoxia’. According to Dr Gopi Krishna, however, many of these symptoms remain rare, and scientists aren’t yet certain if they are directly caused by the SARSCoV-2 coronavirus.
Read on to understand the various types of symptoms and possible damages the virus could cause.
THE UNUSUAL SYMPTOMS
Direct virus causing damage to blood vessels, leading to blood clots formation
Dysregulation or over-activation of one’s own immune system
HEMATOLOGIC MANIFESTATIONS (BLOOD-RELATED CHANGES)
Lymphopenia (WBS, lymphocytes are reduced) Platelets are reduced (blood clots formation) Thrombosis
CARDIO MANIFESTATION (HEARTRELATED MANIFESTATION)
Myocarditis (heart muscle damage) Arrhythmia (irregular heart beat)
Sudden cardiac arrests
Sudden heart and lung failure (Cor pulmonale)
COVID-19 AND ACUTE KIDNEY DAMAGES
Acute kidney injury (AKI) (seen in
10% of patients) Proteinuria (loss of protein in urine)
Hematuria (loss of blood in urine)
Electrolyte disturbances (potassium and sodium salts in body can go up and down causing disturbances in BP and heartbeat rate)
GASTROINTESTINAL MANIFESTATIONS
Severe nausea
Severe loss of hunger Loose motions (seen in 30% patients)
Liver Injury (white jaundice and yellow jaundice for some)
Another couple of issues that Dr Gopi Krishna points out include Kawasaki disease, that is, joint pains and blood vessels affected, which leads to discolouration of toes and fingers (underlying mechanisms being blood vessels damage). The doctor also talks of many patients presenting other symptoms including high blood sugar (hyperglycemia), sometimes going into a state called
ketoacidosis in patients with previously undiagnosed diabetes or no diabetes.
NEUROLOGICAL MANIFESTATIONS
Anosmia (loss of smell) Severe dizziness, myalgias, headaches and fatigue
Dr Gopi Krishna also talks of cases in which a few patients had suddenly gone into brain stroke (paralysis) while a few others have suffered encephalitis (brain Injury). “In one case, we witnessed a dangerous manifestation of the Guillain–Barre syndrome, in which the protecting muscles and nerves are suddenly affected, which leads to sudden respiratory arrest,” the doctor adds.
DERMATOLOGICAL (SKIN) MANIFESTATION
Rashes
Vesicles (like chicken pox lesions)
Petechiae (dark spots on skin)
“Other than causing life-threatening
pulmonary (lung) complications, the virus can affect major organ systems because even a small clot formation in those organs can lead to an organ failure,” adds Dr Gopi Krishna.
TREATMENT
Oxygen
Steroids
Plasma therapy Antivirals (Remidesivir and Favipiravir)
Vitamins (Vitamin C, Vitamin D and Zinc)
Blood thinners (low molecular weight heparin)
Rarely (anti-inflammatory drugs to Tocilizumab)
However, Dr Gopi Krishna cautions that all these trial medications and therapies are to reduce the severity of the disease and that none assure cure.