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'COVID-19 symptoms outside lungs decoded'

Boston: Scientists, including those of Indian-origin, have provided the first extensive review of COVID-19's effects outside the lungs, and have recommended that physicians treat it as a multisystem disease with manifestations including blood clots, kidney failure, and neurological symptoms like delirium. "I was on the front lines right from the beginning. I observed that patients were clotting a lot, they had high blood sugars even if they did not have diabetes, and many were experiencing injury to their hearts and kidneys," said Aakriti Gupta, a co-author of the study from Columbia University in the US.

According to the review of studies, published in the journal Nature Medicine, a substantial proportion of COVID-19 patients suffer kidney, heart, and brain damage.

The researchers recommended that doctors treat these conditions along with the respiratory disease.

"Physicians need to think of COVID-19 as a multisystem disease," Gupta said.

One of the non-respiratory complications most reported by studies is blood clotting, according to the researchers.

They said these clotting complications may stem from the virus' attack on cells that line the blood vessels.

The scientists explained that when the virus attacks blood vessel cells, inflammation increases, and blood begins to form clots, big and small. These blood clots, according to the study, can travel all over the body and wreak havoc on organs, perpetuating a vicious cycle of inflammation.

"Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks the normally protective biological mechanisms. We hope that this would help in the development of more effective treatments for COVID-19 in the near future," said Kartik Sehgal, another co-author of the study from Harvard Medical School in the US.

According to the researchers, the formation of clots can lead to heart attacks.

However, they said the exact mechanism of heart damage in COVID-19 patients is currently unclear since the virus has not been frequently isolated from the heart tissue in autopsy cases. The researchers believe the heart muscle may be damaged by systemic inflammation, and the accompanying release of immune system's signalling molecules, cytokines.

They said a flood of the cytokines which normally clear up infected cells can spiral out of control in severe

COVID-19 cases.

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