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COVID-19 is a respiratory disease with complications that can affect the whole body

by Grailing Anthonisen - August 12, 2020   1273 Views   6 min
COVID-19 is a respiratory disease with complications that can affect the whole body

Claim

COVID-19 is not just a respiratory disease, it hits the entire body

Verdict

Accurate as a whole (with reservations)

Canada’s CTV News reported in May 2020 that COVID-19 is not just a respiratory disease because it can affect the entire body. This claim has also been made by several other media outlets. It’s factual that COVID-19 can lead to a wide range of potential complications across the body. However, COVID-19 is caused by a respiratory virus, the coronavirus, and subsequently officially categorized as a respiratory disease. Our verdict is therefore that the claim above is accurate, with reservations.

Why is COVID-19 a respiratory disease?

As the World Health Organization (WHO) explains, COVID-19 is a disease that is caused by the SARS-CoV-2 virus; genetically, the SARS-CoV-2 virus is part of the coronavirus family of respiratory viruses and is related to Severe Acute Respiratory Syndrome (SARS) and the Middle East respiratory syndrome (MERS), other respiratory illnesses. It is primarily a respiratory virus because it is contracted through the respiratory tract and, according to the Canadian Lung Association, mainly injures the lungs.

If a disease is classified in a particular way, does that mean it doesn’t affect other parts of the body?

The human body is made up of multiple interconnected systems. Sometimes, when something goes wrong in one system, it can affect another part of the body. For instance, blood moves around the body through the circulatory system and absorbs nutrients in the digestive system and oxygen in the lungs through the respiratory system. The blood delivers this oxygen and nutrients to other cells in the body.

Diseases can be contracted in and spread from one part of the body to affect another. For example, influenzas are viral infections that mainly affect the lower or upper respiratory tract. However, they do occasionally, spread and cause complications in other parts of the body. In some cases, influenza can cause inflammation of the heart or brain.

In the case of COVID-19, the virus penetrates cells via specific receptors. It has been shown that the coronavirus has an affinity to the ACE2 receptor which is more commonly found on the lining of the respiratory tract. ACE2 expression is also, to a lesser extent, noted on the surface of heart, ileum, kidney and bladder cells.

What are the symptoms and effects that COVID-19 has on the body?

The Canadian news media reported in their article that in some cases COVID-19 can cause blood clots, multi-system organ failure, swollen toes, and can cause their immune system to overreact. The overreaction of the immune system is thought to be the hallmark of serious respiratory complications in patients requiring respiratory support. This is termed 'cytokine storm'. Part of current therapeutic efforts and research have been looking at how to reduce this storm.

According to WHO, the majority of people—they estimate about 80%—recover from COVID-19 without needing hospital treatment, while around 1 out of 5 people become seriously ill. According to the US Centers for Disease Control and Prevention (CDC), people are at risk for worse complications if they are 60 or older or have underlying health conditions, such as obesity, diabetes, high blood pressure, lung or kidney diseases as well as immune diseases.

According to UK Innovation and Research, like CTV reports, COVID-19’s serious health risks include pneumonia and blood clots in the lungs. The virus can also trigger an inflammatory over-reaction, which is when the reaction of the immune system is so extreme, it ends up fighting uninfected cells as well. The virus can cause clots and this inflammatory response, which can affect other organs, like the kidneys, liver and heart.

Are these symptoms or complications?

Both the US CDC and WHO continue to categorize COVID-19 as a respiratory disease. Both WHO and the US CDC occasionally expand their lists of symptoms. In addition to respiratory 'symptoms' like cough, sore throat and shortness of breath, symptoms now include nausea or vomiting, diarrhea and the loss of sense of smell or taste, in addition to the respiratory conditions, like cough, sore throat and shortness of breath. They do not include blood clots, organ failure or immune system responses.

The Mayo Clinic, however, lists organ failure in several organs, heart problems, acute respiratory distress syndrome, blood clots, and acute kidney injury as “complications” of COVID-19. In medicine, complications are adverse or negative effects that a disease, health condition or treatment can have on a person’s health. A symptom is a primary effect of a disease or health condition, while conditions are secondary effects.

How common are these complications?

Because COVID-19 is a new disease, there is still a lot of research being conducted and more studies need to be conducted to establish the frequency and prevalence of systemic complications. Early reports from some hospitals suggest it occurs in small numbers in severe cases. According to the Weill Cornell Medicine News, the prevalence of blood clots depends on the severity of the case. They mention a study of 400 patients hospitalized with COVID-19, that found clotting occurred in 10% of these patients. About 5% had a severe form of clotting, where clots form deep in the legs or arms and can travel to the lungs or heart, causing serious complications.

According to Johns Hopkins Medicine, kidney damage can occur in severe cases and that early reports suggest that up to 30% of hospitalized COVID-19 patients in China and New York developed moderate or severe kidney injury. They note, however, that despite new research findings it is still unclear how exactly COVID-19 affects the kidneys. It could be that the coronavirus targets the kidneys, it could be caused by low oxygen levels in blood from pneumonia and the virus’s effect on the lungs or caused by blood clots. According to Johns Hopkins Medicine, pneumonia is the most common complication of COVID-19.

In addition, more and more news reports have emerged in the United States and elsewhere in July 2020 sharing anecdotal evidence of longer term neurological and other effects in young people after having had COVID-19. According to a recent study, this could be the result of infection induced blood clots to the brain, bleeding in the brain as well as direct infection via the ACE2 receptor which has been found on brain tissue.

COVID-19 is caused by the respiratory virus SARS-CoV-2. CTV’s claim that it is a respiratory disease that can affect the entire body is accurate, with reservations. Because the human body is so interconnected, diseases in one part of the body can affect other parts of and systems in the body.

How did the SARS-CoV-2 virus get its name?

SARS-Cov-2 is the official name of the virus that causes Covid-19 disease. The name SARS-CoV-2 was chosen because the virus is genetically associated with the respiratory virus that caused the SARS outbreak in 2003. Although they are part of the same family, the two viruses are different. It is the role of the International Committee on Taxonomy of Viruses (ICTV) to decide on the name of a virus, usually based on the genetic structure of the virus, to facilitate the development of diagnostic tests, vaccines and drugs.

Often, viruses and the diseases that result from them have different names. The disease caused by the SARS-CoV-2 virus was named Covid-19 by WHO's International Classification of Diseases, whose role it is to give names to diseases. The name of the disease is a combination of the contraction of the words 'coronavirus' and 'disease' and the number 19, for the year 2019 when the virus was first observed. 

How are diseases classified?

Diseases are categorized according to the International Classification of Diseases. This is a diagnostic tool maintained by WHO to provide an international standard to facilitate comparability in diagnostics and for statistical purposes. It creates a common vocabulary to record, report and monitor health problems across languages and throughout the world. You can read more about this here.

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The Canadian Lung Association

https://www.lung.ca/lung-health/lung-disease/covid-19-coronavirus/faqs

The US CDC

https://www.cdc.gov/flu/symptoms/symptoms.htm

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-increased-risk.html

Johns Hopkins Medicine

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs

Journal of Blood

https://pubmed.ncbi.nlm.nih.gov/32492712/

The Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963

WHO:

https://www.who.int/news-room/spotlight/international-classification-of-diseases

https://www.who.int/classifications/icd/en/

https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses#:%7E:text=symptoms

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

Weill Cornell Medicine

https://news.weill.cornell.edu/news/2020/07/what-is-known-about-covid-19-and-abnormal-blood-clotting

UK Research and Innovation

https://coronavirusexplained.ukri.org/en/article/cad0012/

Elsevier Public Health Emergency Collection

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169933

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204669/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286828/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214348/

Journal of the American Society of Nephrology

https://jasn.asnjournals.org/content/31/7/1380

  Claim

CTV News

Organization
COVID-19 is not just a respiratory disease, it hits the entire body

Verdict:

Accurate as a whole (with reservations)

 August 12, 2020


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