How does COVID-19 cause death?
While COVID-19 is a pulmonary disease that can devastate the lungs, clinical reports and studies are starting to show its widespread effects on the body.
When COVID-19 was first encountered, doctors and researchers thought of it as a kind of pneumonia caused by an unknown pathogen. While COVID-19 is indeed a pulmonary disease that can devastate the lungs, clinical reports and studies are starting to show its widespread effects on the body. There is evidence of an attack on the brain, heart, intestines, and kidneys as well. Another new and surprising development is the increase in the number of strokes in COVID-19 patients, especially the younger ones.
Systemic organ failure is complicated - so far we do not know if the virus is directly attacking the various organs or if widespread organ damage is caused by an out of control immune response called the cytokine storm.
Here is how the virus has been killing people so far:
In most cases that lead to death, the devastation in the lungs is obvious. CT scans of COVID-19 patients reveal lesions throughout. In severe cases, the virus migrates to the alveoli (air sacs) which become inflamed. The ensuing pus and damage make breathing difficult; this is why mechanical ventilation is required, and even then some people die by 'drowning' as their lungs fill up with their body fluids.
Blood clotting disorders
CT scans have shown blood clots throughout the bodies of COVID-19 victims. Large vessel occlusions (LVOs) are major blood clots in the brain that can have debilitating effects on the body - these have been reported in significant numbers as well.
Since ACE-2 receptors (onto which the virus latches on) are present on the lining of blood vessels, some doctors have hypothesized that the virus is directly causing clotting disorders. Deaths from strokes — which are caused by blood clots — pulmonary embolism and heart attacks have been reported in COVID-19 patients. Reports from China have shown that 20% of COVID-19 patients had severe cardiac injury.
The bloodwork of COVID-19 patients has shown elevated levels of proteins that suggest kidney failure. Kidney failure may be responsible for COVID-19 deaths, but again, it is uncertain whether the virus directly attacks the organ or if it is the result of an overactive immune system and the effect of drugs as well.
What can we gather from all this?
There are many unknowns with COVID-19. The classical symptoms such as fever and shortness of breath may be entirely absent in people who suddenly suffer strokes or cardiac symptoms. These clinical findings are suggestive of the virus invading more parts of the body than previously believed. If the cause of death can be determined with more certainty, treatment plans will be able to adapt better.
These findings also corroborate widely circulated public health dogma - the best defence against COVID-19 currently is physical distancing since there may be many ‘silent’ symptoms. If we are to get this pandemic under control, we must do our part in flattening the curve until reliable treatments are found.
For more information, read our article on Complications of severe cases of COVID-19.
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