Effects

Progression Overview

  • Cells invaded by Virus.
  • Viruses multiply. Antibodies start getting tuned to spike protein.
  • 4th or 5th day +- 2 days: First symptoms. Antibodies and viruses battle it out - release cytokines, resulting in fever, body ache, sore throat etc..
  • By 3rd or 4th day after this, fever usually comes down - due to the virus numbers dying down. (For 80% of people, this is the end of the infection effects.) In people who start taking steriods prematurely, this phase is prolonged.
  • For some (10-15%) people, the symptoms become severe. Fever comes back, or becomes higher fever. Cough may turn into a deep hacky dry cough. Chest congestion may lead to breathing difficulty.
    • This is not due to virus or pneumonia (determined from autopsy and research). It is due to blood clotting in the veins, clogging blood flow. Hence, oxygenation is affected. This tendency for clotting remains for up to 3 weeks.
    • Antibodies sensitive to the viral spike protein have begun attacking blood vessels in the lungs, intestines (hence diarrhea), liver and kidneys which have similar proteins. Normal smoothness of interiors of blood vessels is lost, blood cells start sticking there leading to clots.
  • In some of these people, damage accumulates until lung damage is severe - oxygenation in required.
  • Steroid treatment side effects:
    • Opportunistic infections by bacteria and fungi may happen. Often patient feels improvement a day or two after steroid therapy is started, but by 4th day, they start having fever again.
    • They’re diabetogenic. Blood sure in diabetics may shoot to 400 or 500. Pre-diabetics may show diabetes.

Comorbidity

Severe disease can result in people with diabetes, obesity, chronic breathing difficulty (like asthma), compromised immune system.

The very low mortality among the slum dwellers in India have drawn lot of attention.One of the reason could be that due to repeated exposure,their gut microbiome have more of those good microbiome protecting against severe infections.

  • Neanderthal genetic inheritence - more susceptible.

Causal chain

  • Lung epithelial cells are infected.
  • Virus is then detected by macrophages. They produce interferons and cytokines. But the virus is oblivious to anti-viral effects of interferons. Cytokines attract more white blood cells. So there is a cytokine storm from a chain reaction.
  • This results in inflammation, formation of fibrin and damage to lung cells, weakinging of blood vessels leading to seepage and drowning.

Duration

  • “About 80 percent of infections, according to the World Health Organization, “are mild or asymptomatic,” and patients recover after two weeks, on average.”
  • Can last very long - “When I spoke with LeClerc on day 66, she was still experiencing waves of symptoms. “Before this, I was a fit, healthy 32-year-old,” she said. “Now I’ve been reduced to not being able to stand up in the shower”" AT

Short term effects

Severity

  • Initial estimates: “For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.” - WHO-2020-03-06
  • Indian scenario highest mortality between the age 40-70 years. 56% of the severely affected in India are under 40’s.
  • Indian population at large has a genetic predisposition to develop severe pneumonia due to the virus. This same expression has been found among Russians,Europeans explaining higher mortality there and less with Africans.

Long term effects

  • 47k hospitalized patients NHS UK data - 10% ICU-ed. 90% discharged. Within few months of discharge, 1/3 readmitted, 1/8 die.-
  • Higher heart, liver, kidney diesase.
  • 7-8% of children and young adults developing long term symptoms according to UK data. Tiredness, inability to concentrate.

Heart

  • Several cases are getting reported of young adults sent home after 7 days with a negative result, develop sudden symptoms and die. Suspected cause: The small blood vessels of the heart had intense inflammation an entity known as MIS(Multi System Inflammatory Syndrome),see the photograph taken attached below. FB Exercise should be avoided for some time.
  • Scientists took the mother cells called stem cells that differentiate to heart muscle cells and infected them with the virus. Within 72 hours,the virus could cause death of cells and stop the cells contracting. cell
  • 35% infected athletes got myocarditis. ““extremely dangerous” for athletes diagnosed with myocarditis to play competitive sports for at least three to six months, because of the risk of serious arrhythmia or sudden death”
  • Case of Dr Praveen of London: “I had bad chest symptoms for 3 months now fully normal.”

Brain

  • Cov2 virus can disrupt this blood brain barrier and enter brain cells and infect them directly.
  • Cognitive penalty: medarxiv. “People who had recovered, including those no longer reporting symptoms, exhibited significant cognitive deficits when controlling for age, gender, education level, income, racial-ethnic group and pre-existing medical disorders. They were of substantial effect size for people who had been hospitalised, but also for mild but biologically confirmed cases who reported no breathing difficulty.”
  • It exploits the brain cells’ machinery to multiply, but doesn’t destroy them. Instead, it chokes off oxygen to adjacent cells, causing them to wither and die.
  • The coronavirus seems to rapidly decrease the number of synapses, the connections between neurons. “Days after infection, and we already see a dramatic reduction in the amount of synapses,” Dr. Muotri said. “We don’t know yet if that is reversible or not.”
  • NYT2009
  • MRI based study has demonstrated micro structural defects in olfactory (smell recognition area) and hippocampus (short term memory area) which translated to loss of smell that is widely known in acute setting to memory loss observed 3 months later.

Stroke

  • Cerebral Venous Thrombosis (CVT)is a known complication from the COVID virus. Strokes and paralysis follow if not cleared.

Lung scarring

  • 6 weeks and 12 weeks after discharge,the scarring decreases (Pics FB )
  • Many around the world are suffering with shortness of breath,chest tightness 3 months post infection.

Eye

  • Sudden vision loss due to occlusion of blood vessels supplying the eye increasingly recognized these days. Doctors advise retina scan post recovery.

Cognition

  • The pre-print study from Macaque monkeys infected with the virus forming what are called Lewy bodies which are nothing but abnormal protein deposits in the brain. These deposits are linked with development of neurodegenerative conditions like Parkinson’s disease and dementia.

Other effects

  • Multi-system inflammatory syndrome in children (MIS-C)
  • 26% of those admitted to ICU from COVID had invasive fungal infections.
  • Auto immune disorders like guillan barre.

Progression anecdotes

M 2022-07

M (vaccinated from USA, visiting India) caught it first and passed it on (St, Se, Ja, R infected in the household - Ap, M escaped). Mild flu like symptoms started with head ache and sore throat then cough and fatigue for a day and low grade fever. Others had fever and a bit of body ache. Transitioned to loss is smell and then it back to normal. In a span of 5 -6 days but for the test to come negative takes about 12 days.