Does COVID-19 only affect lungs? AIIMS experts discuss extra-pulmonary manifestations of deadly virus

The experts at AIIMS asserted on Thursday that manifestations of COVID-19 virus goes far beyond pulmonary complications that previous studies suggested. The virus may also cause simple Anosmia to life-threatening Encephalopathy or sudden cardiac arrest.

They also suggested that the classification of COVID-19 based on respiratory symptoms into mild, moderate, and severe cases needs to be revamped.

Randeep Guleria, director at the All India Institute of Medical Sciences observed that the virus' manifestations vary, affecting across organ systems.

Guleria shared his observation during the weekly "National Clinical Grand Rounds", organized by AIIMS while discussing various possible extra-pulmonary complications of the Coronavirus.

He further explained that though pulmonary manifestations continue to dominate in most cases of the pandemic, there are many COVID-19 patients who have extra-pulmonary manifestations.

During the discussion, the experts presented several cases where the patients had developed complications in the body other than the respiratory system.

Neeraj Nishchal, Associate professor in the medicine department at AIIMS, said what started as viral pneumonia is now turned into a multi-systemic disease. "It ranges from simple Anosmia to life-threatening Encephalopathy or sudden cardiac arrest. Almost all organs have some or other manifestation attributed to COVID-19 disease," he added.

Ayush Agarwal, assistant professor in the Neurology department, AIIMS, said that the hospital has seen 31 cases of COVID-19 positive strokes in the last six months. "Seventeen cases were ischemic, 13 were hemorrhagic, and 1 was CVST. All these patients were asymptomatic or minimally symptomatic for pulmonary manifestation," he informed.

Agarwal added that brain stroke was the primary neurological manifestation found in COVID-19 positive cases. "However, it happens only in patients with severe infections and older with multiple vascularis factors," he said.

Deepti Siddharthan, assistant professor in the cardiology department, AIIMS, observed that a 58 percent increase in outer hospital cardiac arrest cases correlated with Covid has been recorded since the pandemic started. She also said that cardiovascular involvement in COVID-19 infection might infest as myocardial injury and acute coronary syndromes.

"Cardiac conduction disturbances can also be associated with Covid-19 infection irrespective of the severity of the disease and myocardial involvement," Siddharthan added.

COVID-19 has affected more than 33 lakh people, with 60,472 deaths so far. India has recorded 75,760 fresh COVID-19 cases with 1,023 deaths, in the last 24 hours.

India now has 7,25,991 active cases with 25,23,772 deaths.

(With IANS and ANI inputs)