Lingering pathologies: SARS-CoV-2 could be doing long term damage to the body

It is just as capable of attacking the cholangiocytes of the liver as it is capable of attacking the epithelial cells that line blood vessels.

A consensus seems to be developing that SARS-CoV-2 could be a multi-system, or, worse, a systemic, pathogen that has the potential to attack the human body virtually from head to toe. Eminent pulmonologist, AIIMS director, and one of the country’s foremost experts on Covid-19, Dr Randeep Guleria, in an interview with The Indian Express, talked about poor lung condition in patients months after recovery, and patients suffering from stroke and neurological pathologies. This paper had earlier talked about how the SARS-CoV-2’s multiple-front attacks on the human body made it difficult to treat—from anti-retroviral drugs to corticosteroids, monoclonal antibodies to hydroxychloroquine, existing drugs and therapies that have widely varying lines of action in the body and target fundamentally disparate pathologies have been put to off-label use, with both success and failure reported. However, while the emerging nature of the virus has made the discovery of a drug or a vaccine an absolute imperative, health policy will also need to focus on the fact that the virus is not just a threat for the present—its debilitating impact on the body is a concern for the future as well.

Organoid studies—virologists using lab-generated, organ-simulating tissue to study the impact of the pathogen in a more holistic manner than just cell-line studies—have shown that SARS-CoV-2 infection not only complicates pre-existing conditions and triggers immune system overdrive, but also is capable of directly attacking a range of organs and tissues in the body. It is just as capable of attacking the cholangiocytes of the liver as it is capable of attacking the epithelial cells that line blood vessels. There are now multiple studies showing how grave a threat the virus presents to the cardiovascular system. A study amongst patients in China’s Hubei and Sichuan provinces pointed at extensive kidney damage among a lot of patients. Then, there are reported observations of several neuropathologies—including encephalitis like conditions, seizures and sympathetic storms. With diarrhoea included in the list of Covid-19 symptoms—and the detection of the virus in wastewater samples in Spain—it is clear that the virus affects the gastrointestinal system, too. Researchers are now investigating if the virus also triggers type-1 diabetes among some patients by either directly attacking the site of insulin production in the body or by triggering an immune system action that does this. Add to this the reports of Kawasaki-like symptoms among children who tested positive for the virus, and the virus emerges as likely the most formidable pathogen humanity has confronted in a long time. Conventional disease response is being challenged, as is disease research; this means that there has to be a concerted global effort to capture every case and collaborate to detail and study every aspect of the virus and its impact on the body if humanity has to have any hope of getting rid of it for good.