Hartford Courant (Sunday)

What virus does to the human body And what medical experts, researcher­s still don’t know as deaths, infections jump across the globe

- By Pam Belluck The New York Times

As cases of coronaviru­s infection proliferat­e around the world and government­s take extraordin­ary measures to limit the spread, there is still a lot of confusion about what the virus does to people’s bodies.

The symptoms — fever, cough, shortness of breath — can signal any number of illnesses, from flu to strep to the common cold.

About 5,800 people have died worldwide and over 155,000 people have been infected. There have been more than 50 deaths in the United States and over 2,000 Americans have been infected.

Here is what medical experts and researcher­s have learned about the progressio­n of the infection caused by this new coronaviru­s — and what they still don’t know. the alveoli or lung sacs, and they have to work harder to carry out their function of supplying oxygen to the blood that circulates throughout our body and removing carbon dioxide from the blood so that it can be exhaled.

“If you get swelling there, it makes it that much more difficult for oxygen to swim across the mucous membrane,” said Dr. Amy Compton-Phillips, chief clinical officer for the Providence Health System, which included the hospital in Everett, Washington, that had the first reported case of coronaviru­s in the country, in January.

The swelling and the impaired flow of oxygen can cause those areas in the lungs to fill with fluid, pus and dead cells. Pneumonia, an infection in the lung, can occur.

Some people have so much trouble breathing, they need to be put on a ventilator. In the worst cases, known as Acute Respirator­y Distress Syndrome, the lungs fill with so much fluid that no amount of breathing support can help, and the patient dies. helps explain why in Wuhan, where the outbreak began, many of the earliest cases were not identified immediatel­y.

The initial testing regimen in many Chinese hospitals did not always detect infection in the peripheral lungs, so some people with symptoms were sent home without treatment.

“They’d either go to other hospitals to seek treatment or stay home and infect their family,” he said. “That’s one of the reasons there was such a wide spread.”

A recent study from a team led by researcher­s at the Icahn School of Medicine at Mount Sinai in New York found that more than half of 121 patients in China had normal CT scans early in their disease. That study and work by Xiao show that as the disease progresses, CT scans show “ground glass opacities,” a kind of hazy veil in parts of the lung that are evident in many types of viral respirator­y infections. Those opaque areas can scatter and thicken in places as the illness worsens, creating what radiologis­ts call a “crazy paving” pattern on the scan. the bloodstrea­m, Schaffner said.

The U.S. Centers for Disease Control and Prevention says that RNA from the new coronaviru­s has been detected in blood and stool specimens, but that it’s unclear whether infectious virus can persist in blood or stool.

Bone marrow and organs like the liver can become inflamed too, said Dr. George Diaz, section leader for infectious diseases at Providence Regional Medical Center in Everett, Washington, whose team treated the first U.S. coronaviru­s patient. There may also be some inflammati­on in small blood vessels, as happened with SARS, the viral outbreak in 2002 and 2003.

“The virus will actually land on organs like the heart, the kidney, the liver, and may cause some direct damage to those organs,” Schaffner said. As the body’s immune system shifts into high gear to battle the infection, the resulting inflammati­on may cause those organs to malfunctio­n, he said.

As a result, some patients may endure damage that is inflicted not just by the virus but by their own immune system as it rages to combat the infection.

Experts have not documented whether the virus can affect the brain.

But scientists who studied SARS have reported some evidence that the SARS virus could infiltrate the brain in some patients. Given the similarity between SARS and COVID-19, the infection caused by the new coronaviru­s, a paper published last month in the Journal of Medical Virology argued that the possibilit­y that the new coronaviru­s might be able to infect some nerve cells should not be ruled out.

 ?? GETTY-AFP ?? A patient rests at a temporary hospital set up for COVID-19 patients earlier this month at a sports stadium in Wuhan, the epicenter of China’s outbreak, in Hubei province.
GETTY-AFP A patient rests at a temporary hospital set up for COVID-19 patients earlier this month at a sports stadium in Wuhan, the epicenter of China’s outbreak, in Hubei province.
 ?? YONHAP ?? Soldiers in protective gear spray disinfecta­nt as part of preventive measures against COVID-19 in Daegu, South Korea.
YONHAP Soldiers in protective gear spray disinfecta­nt as part of preventive measures against COVID-19 in Daegu, South Korea.

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