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Strokes, heart, neurological issues arise in 'serious' COVID cases, doctors say

Northwestern Medicine Cardiologist Asim Zaidi speaks with the Northwest Herald on May 14, 2020 about serious but more rare symptoms and side effects associated with COVID-19.
Northwestern Medicine Cardiologist Asim Zaidi speaks with the Northwest Herald on May 14, 2020 about serious but more rare symptoms and side effects associated with COVID-19.

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Coughing, fever, sore throat – these are the symptoms we’ve come to associate with COVID-19.

But medical experts have noted additional – although rare – side effects of the virus on patients’ heart, brain, and kidney function.

“The question we don't fully understand yet is: is the virus attacking these organs directly or is this the manifestations of a severe infection that the body's dealing with on these organs?” Northwestern Medicine Cardiologist Dr. Asim Zaidi said.

Studies suggest that COVID-19 causes “severe inflammation,” which could put a strain on the heart and kidneys, although the connection isn’t entirely understood yet, Zaidi said.

“Everyone over the world is publishing new information every day, and so we're still in the learning phase of everything,” Zaidi said.

In certain circumstances, ailments like headaches and strokes have been linked to COVID-19, said Dr. Matthew Tyler, a critical care specialist with Advocate Health. Some patients have even experienced a sudden loss of taste or smell while those in need of a ventilator commonly suffer added anxiety, he said.

"I don't think we have a clear sense of the pathophysiology of why [loss of taste or smell] happens. And then another item that we have noticed – unfortunately, once the patients have required a ventilator, they can get very anxious, which is completely understandable," Tyler said. "These patients are lucid, they're awake, they're alert. It's just the lungs are failing. And so they need a breathing tube. They need a ventilator, but they're still awake."

Inflammation associated with COVID-19 also can lead to heart and kidney complications – seemingly the result of the virus’ effect on the body and conditions that arise from that strain, Zaidi said.

“In any severe infection, we see things that can upset the fluid balance in the body that can put the kidney under some strain, particularly with the heart, where my area of expertise is, that the inflammation can cause some fatty deposits in the heart arteries to break off, and that can lead to a typical heart attack,” Zaidi said.

The virus also has been linked to certain neurological symptoms including strokes in what Zaidi called “severe episodes of COVID.”

“Patients are developing blood clots that can be in the legs, and it could be sometimes very rarely in the heart, but essentially, again, it's not that the virus is making the blood stick,” Zaidi said, “It's the way the body's trying to treat itself makes the blood stickier and if that blood clot goes into an artery and…to the brain, that can cause a stroke.”

As medical experts work toward a better understanding of the virus, it’s important to remember that most COVID-19 patients experience only mild symptoms, Zaidi said.

“Broadly speaking, 80% of patients have mild symptoms and don't require hospital-based treatment, and 20% require hospital-based treatment,” Zaidi said. “And generally speaking, about 4% require treatment in the intensive care unit, and it's in that 4%, where we're seeing more involvement in different organs. So, they're the ones that typically have more strain on the heart and kidney function.”

For now, Zaidi and Tyler recommend that people follow guidance from the Centers for Disease Control and Prevention. Washing hands frequently and wearing a mask or face covering help reduce the transmission of COVID-19 by limiting the spread of germs and water droplets that can carry the virus.

“We're learning as we go. We have gotten a lot of useful information out of previously hit countries, China, Italy, and there's a lot of new information coming out this way,” Tyler said. “You can't pick up a medical journal without there being you know, half a dozen COVID papers.”

As experts continue to learn more about COVID-19, it’s important for health care workers and every-day citizens to not get lax with their prevention efforts, Zaidi said.

“You don't want to start thinking, ‘OK, well, I've been OK so far, you know, let me just not wear my mask while I walk up the elevator or something.’ That's the thing that you just have to constantly remind yourself, because this is dragging on,” Zaidi said. “This is not the end of it, and so we just have to keep our guard up. Otherwise, we're going to go backwards.”

As of Wednesday afternoon, McHenry County was home to 1,493 cases of COVID-19 and 72 deaths, according to the McHenry County Department of Health. That’s compared to 7,845 positive cases and 270 deaths in Lake County, and 5,947 cases and 162 deaths in Kane County, according to the IDPH, whose numbers may vary slightly from local health departments'. Will County reported 5,279 positive cases and 264 deaths.

Lower numbers were reported in DeKalb County, which saw 334 positive cases and three deaths as of Wednesday afternoon. Nearby, Kendall County was home to 736 cases and 19 deaths, while La Salle County saw 140 cases and 13 deaths.

Although people above the age of 60 or with underlying health conditions are more vulnerable to COVID-19, young and otherwise healthy people also have contracted the virus, Tyler said.

“Some people obviously are hearing that people will have very minimal symptoms and they'll hardly even know that they have a virus. And from a numbers standpoint, OK, you'll be fine. Unfortunately, there's 27% of people who are actually getting pretty sick,” Tyler said. “And some of these individuals are young and healthy. So, it's the unpredictability of this disease that's scary.”

Even as Illinois progresses through Gov. JB Pritzker’s five-phase Restore Illinois plan, the risk of overrunning the health care system remains.

“This virus can spread like wildfire, especially within families. So people really need to kind of isolate themselves and try to weather the storm,” Tyler said. “It's potentially going to be a long haul. This may not be something that's going to be gone by September. There is certainly high risk for a second wave, especially as other viral illnesses such as the flu are starting to emerge.”

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