• Xiaoying or Elizabeth Yuan

How Does COVID-19 Affect the Heart, Lung and Kidneys?

by Wei Laboratories (www.weilab.com)

The SARS-CoV-2 contains a surface glycoprotein also called spike proteins or S protein that studs the viral envelope and binds only with specific receptors on the cell surfaces. Such receptors include angiotensin-converting enzyme 2 (ACE2) in the respiratory epithelium and other organs such as the arteries, heart, kidney, and intestines. The binding of the spike S1 protein to the ACE2 results in endocytosis and translocation of both the virus and the enzyme into endosomes inside cells. About 1 in 6 individuals will have further complications in the lung, heart, and kidneys. These organs have high amounts of ACE2, the receptor of the SARS-CoV2, that enable the coronavirus to attach to them, invade, replicate, and damage the tissues. When the virus enters into the cell, the immune system activates large amounts of inflammatory mediators. Large amounts of cytokines in the blood can damage and kill tissues in the lungs, heart, and kidneys. Kidneys Some people suffering from severe cases of COVID-19 are showing signs of kidney damage, even those who had no underlying kidney problems before they were infected with the coronavirus. Signs of kidney problems in patients with COVID-19 include high levels of protein in the urine and abnormal blood work. The tiny clots can clog the smallest blood vessels in the kidney and impair its function. Heart Studies have found that some individuals develop acute cardiac injury following infection of COVID-19. Though a good portion of these patients already had underlying health issues involving the heart, like heart disease or high blood pressure, many otherwise healthy patients have also developed heart problems, including blood vessel injuries, blood clots, arrhythmia, strokes, and heart attacks. The large cytokine storm can directly damage the heart and cause myocarditis with heart muscle cell necrosis. Lungs Acute respiratory failure and acute respiratory distress syndrome (ARDS) can occur in the lungs which triggers severe lung inflammation and causes pneumonia. Blood clots in one of the artery branches can prevent blood from going to certain segments of the lung while the blood clots in the capillary-level vessels can prevent the transfer of oxygen to the blood. In severe and very ill COVID-19 patients, the lungs fill with fluid, pus, and cellular debris and their respiratory system eventually fails. Most patients recovered completely with some residual cough and shortness of breath. But a certain population has excessive lung damage and some of them end up with fibrosis of the lung.

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