The sequelae that COVID-19 leaves in those who survive it in the ICU: kidney, neurological, cardiac and muscle damage

COVID-19 is still a disease with many unknowns. However, its severity is something that cannot be discussed. The consequences of a case complicated by COVID-19 are numerous and important.

Overcoming the disease does not have to be the end, it can be the beginning of a difficult recovery for some people. Patients who go through intensive care and recover can suffer a large number of important sequelae: muscular atrophy, greater chances of suffering vascular accidents, kidney problems or even psychological problems. As we learn more about the disease, the more important its consequences become.

What Happens When COVID-19 Is Complicated

Typical coronavirus symptoms include fever, cough, and shortness of breath. Less well known are complications from the disease. At this point, according to official information, the vast majority of complications come from pneumonia caused by damage to the lungs. The studies carried out to date agree that the virus, although it affects in a general way, especially attacks lung tissue.

This causes a malfunction and the entry of other pathogens that aggravate pneumonia, which is an infection and inflammation of the lungs. Pneumonia prevents breathing, as it damages the alveoli and gas exchange. As a consequence, the body has access to less oxygen. Hence, one of the main needs is to have respirators to compensate for this lack of it.

But this is not all. Pneumonia can continue with sepsis, a widespread infection. Lack of oxygen can cause problems in other organs affected by the virus. There has even been significant neurological damage, as we will now see. This has a great weight not only when it comes to overcoming the disease, but also once we have left the hospital.

Diseases that come after the coronavirus

SARS-CoV-2 infection has consequences at various levels. One of the best known is associated with pneumonia and the lack of oxygen caused by it, but it is not the only one. Lack of irrigation, neurological damage or cytotoxicity cause damage to various parts of the body. These are the main problems detected in some patients cured of COVID-19 and who went through the ICU:

Chronification of pneumonia

The first signs observed in the first serious patients who have overcome the disease show a rather worrying face: the chronification of the disease. Many of the patients who have overcome their stay in the ICU face recurrent inflammation derived from immune problems caused by the disease, according to specialists from the Department of Internal Medicine of the Clinical Hospital of Erlangen.

Kidney damage

Hypoxia itself can cause damage to the kidneys, something that has been observed in association with pneumonia, both viral and COVID-19 or other types. According to nephrologist Michael J. Ross, professor of Medicine and professor of Developmental and Molecular Biology at the Albert Einstein School of Medicine, between 20 and 30% of those admitted to the ICU need dialysis during their recovery and may also after go out from the hospital.

Muscular atrophy

Another chronic disease reported by the Massachusetts General Hospital Division of Neuromuscular Medicine among recovered patients is muscle atrophy. This is not only characteristic of the coronavirus, but of all diseases that require a long time with assisted ventilation and prolonged hospitalization. Its incidence is not trivial, as it affects between 25 and 90% of patients, according to data from the ATEI Thessaloniki Nursing Department.

To compensate for this problem, there are protocols to keep critically ill patients on the move. However, the case of COVID-19 makes it much more difficult to transfer the patient to a rehabilitation room, or even to have a professional approach to treat them.

Cardiorespiratory problems

In 2015, epidemiologist Sachin Yende, from the University of Pittsburgh Medical Center, published a major review linking ICU stay for pneumonia to an increased risk of cardiovascular disease in the years following recovery. Specifically, the specialist indicated that patients are up to four times more likely to have a vascular accident. That includes those affected by COVID-19 with a picture complicated by pneumonia, of course.

Neurological problems

Associated with the disease, doctors have described headache, dizziness, myalgia and the already known anosmia (the inability to smell). Several major neurological consequences have been reported among Wuhan patients who have overcome the disease: encephalopathy, in a 74-year-old man, or ataxia, epilepsy, and peripheral nerve damage, in various patients. Among the mechanisms of affection, indicate the doctors of the Department of Anesthesiology and Perioperative Medicine of the Hospital of the Nanjing University of Medicine, in China, is inflammation of the brain, hypoxia and viriasis.

Little is known about how the virus affects neuronal tissue, since some of its molecular mechanisms are not fully understood. But, according to the studies that we pointed out before, there is a combination of damage due to lack of oxygen and from the infection itself that can negatively affect the brain of recovered patients.

Images | Hospital Clinic / Flickr, Unsplash

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