That's right folks. I was diagnosed with COVID19 also known as Kung Flu. Ive had it since last week. Ive had flus worse than this. But I find the complete lack of smell disturbing. Anyone have a cold or flu that knocked out their sniffer?
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What are you thoughts about covid 19 invading heart cells through the ace2 receptor. If that is true youd think that would cause the immune system to attack the heart.
So ACE2 is predominantly found in the lungs, and in smaller concentration in the colon (small intestine) and arteries/heart. This agrees nicely with the perceived effects— lung problems, diarrhea (from colon involvement), and vascular disease (that hypercoagulable stuff I was talking to you about). BUT just because it enters those cells through that mechanism does not imply that it causes the immune system to attack the heart. That would be an autoimmune reaction.
It is believed that in any kind of inflamed state (such as that with infections, cancer, etc) there is a higher chance of autoimmune conditions. Basically the inside of cells look “foreign” to the immune system because the immune system largely sees the outside only. In inflammatory conditions, those things on the inside get exposed to the outside. Current evidence does not support the notion of a statistically significant increase in autoimmune conditions as a complication of Covid compared to any other infection. So it is not believed that Covid increases your chances of an autoimmune condition more than any other virus as of right now.
Most damage done by viruses is by the virus replicating in the cells. (As opposed to bacteria that produce exo and endo toxins). Think of the host cell like a plastic bag— the more times the virus replicates, the greater the chance that cell pops and causes a local inflammatory response (not usually large enough/systemic of an inflammatory response that induces autoimmune conditions though).
Ahh this was insightful and this makes sense. Since youre seeing these covid patients i have to ask, do you ever get a follow up from them after they recover? Their heart? Lungs? Kidney function?
Yessir— I’m training for my Cardiology fellowship which unsurprisingly involves all of the above-mentioned organ systems. Basically, if your cough resolves, you are 99.99% in the clear. Some (diabetics and heart disease) patients are mild risk for possible infarction due to the clot formation even after their cough resolved, but even within that specific demographic it is less than 5-10%. They appear to be at that mild level of risk for a few weeks; if a heart attack were to happen, it would usually be within a week or two of discharge. Here is the patient at highest risk for that:
65+ year old male, smoker, obese (BMI >30) who doesn’t exercise, has uncontrolled diabetes (Hemoglobin A1C > 7 & doesn’t take their meds), and has heart disease that runs in the family.
Any of those factors increase the risk of a cardiac event. My recommendation is weekly follow up with primary care for 2-3 weeks post-discharge. After about a month, you can make it more infrequent until your risk has dropped sufficiently.
With COVID apparently causing problems to the vascular symptoms what are you seeing as far as strokes, rapid onset dementia, or just general brain fog? Or put another way. How is the brain responding to COVID?