As pandemic deepens, virus symptoms multiply
12 May, 2020
Every week, it appears, the list of coronavirus symptoms -- which range from disagreeable to the deadly -- grows longer.
What started as a familiar flu-like cluster of chills, headaches and fever has rapidly expanded during the last three months into a catalogue of syndromes affecting virtually all your body's organs, from the brain to the kidneys.
The new coronavirus may also push the immune system into overdrive, unleashing an indiscriminate assault -- referred to as a cytokine storm -- on pathogens and their human hosts alike.
"Most viruses could cause disease in two ways," explained Jeremy Rossman, a senior lecturer in virology at the University of Kent.
"They can damage tissue where the virus replicates, or they are able to cause damage as a side-effect of the disease fighting capability fighting off the condition."
Doctors suspect, for instance, that COVID-19 is behind the hospitalisation in recent weeks of several dozen children in New York, London and Paris identified as having a rare inflammatory disorder similar to toxic shock syndrome.
Affecting mainly small children, the painful disease attacks artery walls and may cause organ failure.
A large number of medical studies in recent weeks have detailed other potentially lethal impacts including strokes and heart damage.
Researchers from the urology department of Nanjing Medical University, writing this week in Nature Reviews, described patients developing extreme urinary complications and acute kidney injury.
In addition they observed "dramatic changes" in male sex hormones.
"After recovery from COVID-19, teenagers who are considering having children should get a consultation regarding their fertility," they concluded.
Does which means that that COVID-19 causes a uniquely broad selection of symptoms? Definitely not, virologists and other professionals say.
"If it's a common disease, then even rare issues may happen frequently," Babak Javid, a consultant in infectious diseases at Cambridge University Hospitals, told AFP.
There are nearly 3.8 million confirmed COVID-19 cases all over the world, but the true number of infections -- considering undetected and asymptomatic infection -- "will be in the tens, possibly hundreds of millions," he said.
"So if one-in-1,000, and even one-in-10,000, get complications, that is still thousands of people."
A number of the rarer symptoms connected with COVID-19 are also recognized to have already been triggered by influenza, which kills several hundred thousand persons worldwide each year, he noted.
For the brand new coronavirus, frontline general practitioners around the world have been the first ever to look for patterns in the unfolding pandemic.
"First, we were told to watch out for headaches, fever and a light cough," recalls Sylvie Monnoye, a family group doctor in central Paris for almost three decades.
"They added a runny nose and a scratchy throat. From then on, digestive problems, including stomach aches and extreme diarrhoea."
The list kept growing: skin damage, neurological problems, sharp chest pains, loss of taste and smell.
"We started to feel that we have to suspect everything," Monnoye said, dressed from head-to-toe in protective wear.
Some patients were so terrified, she added, that they cowered in the corner of her office afraid to touch anything or get too near her.
An interior US Centers for Disease Control (CDC) report with a break down of symptoms for 2,591 COVID-10 patients admitted to hospital between March 1 and could 1 chimes with such anecdotal accounts.
Three-quarters of the patients experienced chills, fever and/or coughing, with almost as many showing shortness of breath.
These are, by far, the most common COVID-19 symptoms.
Nearly a third complained of flu-like muscle aches, while 28 percent experienced diarrhea and 25 % nausea or vomiting, in line with the internal report, leaked to the media.
Some 18 percent had headaches, while 10 to 15 percent were hit by chest or abdominal pain, runny nose, sore throat and/or a feeling of confusion.
Significantly less than one percent of the CDC cohort had other symptoms, including seizures, rashes and conjunctivitis.
Health authorities have already been slow in alerting the general public to this panoply of possible impacts.
Until the end of April, the CDC itself only listed three on it's website: coughing, fever and shortness of breath. The update included only a few more: chills, muscle pain, headaches and loss of smell or taste. France's health officials made an identical update on, may 5.
A lack of smell and taste was found in only 3.5 percent of patients contained in the CDC report, but specialists suspect these symptoms are -- for reasons unknown -- a lot more prevalent in less severe cases where people were not hospitalised.
Monnoye said it was among the most frequent of the symptoms she encountered, and agreed that it had been "probably associated with a milder type of the disease".
"I don't have any patients with these symptoms who had serious complications," she said.
The increased loss of taste and smell, authorities note, is extremely rare with other styles of virus.
Another cluster of symptoms rarely found with in flu patients appears to arise from blood clots.
Heart disease, liver thrombosis, lung embolisms and brain damage in COVID-19 patients have been traced to such clots in a flurry of recent studies. Others have described kidney failure and even gummed-up dialysis machines.
"When one is very sick with COVID, you might have a problem with blood clots forming, and that appears to be much, a lot more common than with other viral infections," added Javid. "Compared to influenza, you are more likely to be seriously ill, and die."
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