Taking care of an ICU patient with COVID-19 at Maimonides Hospital in Brooklyn. Washington Post photo. 4/15/20Paul Goldfinger, MD, FACC
Ocean Grove. April 15, 2020.
Washington Post April 15, 2020: Covid-19 kills by inflaming and clogging the tiny air sacs in the lungs, choking off the body’s oxygen supply until it causes organ failure. But doctors are seeing that the virus may be causing heart inflammation, acute kidney disease, neurological malfunction, blood clots, intestinal damage and liver problems.
As we have pointed out, this epidemic is, from a medical point of view, creating more questions than answers even as new questions tumble out of ICU’s and research labs all over the world. The earliest observation was that the virus attacks and damages the small lung air spaces causing oxygen lack around the body and leading to the need for ventilator care.
But so many have been dying despite the ICU and ventilator approach, that other ideas are being considered. American physicians have been obtaining a great deal of information from researchers in Wuhan, China and from their own, in the trenches, observations.
It is now becoming clear that the virus attacks other organ systems directly including the kidneys resulting in renal failure and need for dialysis.
Liver damage causes liver failure, and the virus attacks the linings of the intestinal tract as well.
In some patients, the immune system reacts by spewing out damaging substances called cytokines, resulting in “cytokine storms.”
And other issues include neurologic damages, heart injury, and blood clots in the legs which can cause pulmonary embolism.
So it seems that the coronavirus infections can overwhelm most of the body’s systems and overwhelm the ability of healthcare workers to save patients from death or lingering and nonredeemable complications.
I can imagine the scenes in ICU’s all over the world, where patients tumble downhill with one problem on top of another, after another, after…. I can imagine the stress on the doctors, nurses and other medical personnel who try to plug holes in the dyke, but then other leaks pop open. I can picture the horror that they experience as they lose one patient after another.
And I can imagine the terror in the hearts and souls of patients and their families.
It must be like a tsunami hitting a peaceful island of tranquility and then tearing it apart in no time.
It’s hard to believe that this disaster will completely subside for some time. The search is on for all sorts of ways to stem the tide. And all of us who are outside looking in and getting frightened for ourselves and our families can only do what we are told and asking everyone else to do the same.
JUDY KUHN ;”Dividing Day” from Adam Guettel’s The Light in the Piazza
“Beautiful is what you are,
Only somehow wearing a frightening disguise.
I can see the winter in your eyes, now, telling me:
We are together but I have had Dividing Day.”