But other symptoms have since joined the list.
Reports from COVID-19 patients who have lost their sense of taste and smell, which show signs of unusual blood clots, foot lesions which are sometimes called “COVID toes”, headache, nausea and rare inflammatory diseases in pediatric patients have all hit the headlines in the past few weeks. The list of possible symptoms of COVID-19 seems to be growing.
So how does one virus cause so many symptoms?
One possible explanation: this is not the case.
Dr. Gerald Evans, President of the Division of Infectious Diseases at Queen’s University, suggests that many of the symptoms currently attributed to COVID-19 are already present at similar levels in the general population, or are the effects of any serious infection – not just new coronavirus infections.
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For example, he said, conjunctivitis is present in about 0.8% of COVID-19 cases according to a study. “So what’s interesting is that if you look at the incidence of conjunctivitis in the general population, it’s 0.8%. So I think that sums up the problem you have. “
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Other symptoms, such as nausea or headache, are already experienced by millions of people around the world for a variety of reasons, he said, and it can be difficult to attribute these specific things to single coronavirus. Even conjunctivitis is associated with many viral infections, including measles.
However, while doctors ask their patients questions to try to understand what is going on, many common or general symptoms may be mistakenly associated with the disease.
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Another possible explanation, according to Jason Kindrachuk, holder of the Canada Research Chair in Emerging Viruses at the University of Manitoba, is that because 3 million people have now been diagnosed with COVID-19, we notice more very rare symptoms – simply because the numbers are so high.
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He saw a similar effect when he studied Ebola, he said. At first, when there were relatively few cases, doctors thought they had a good idea of the appearance of the disease.
But during the 2014 epidemic in West Africa, so many people were infected that doctors had a much better idea of all the possible effects of Ebola.
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“2014 strikes and we have tens of thousands of cases. And now you’re starting to get a little bit more clue about the nuances of the disease, “he said.
“It may not fit the model we had, because we are seeing this in a much larger number of patients at very variable stages of the disease right now.” You don’t just see people who are ultra-sick, you see people who may be more mildly sick. “
Likewise, with all of these millions of COVID-19 cases, he does not think we are seeing new disorders arising, but rather the relatively rare effects that only occur in a handful of people.
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The reason a virus can cause so many different effects is the “million dollar question,” Kindrachuk said.
The coronavirus is believed to target mainly the lungs, he said. “But what we are starting to see with some of these different viruses is that in more serious illnesses, these viruses enter many different organs. “
When this happens, a patient’s immune system can “overwork” to try to fight the infection – something it says can lead to many of the more serious complications associated with COVID-19, such as kidney failure.
“What we think is that the virus is entering. It basically causes an overreaction of the immune system or a malfunction or dysfunction. And what will happen is that the disease will start to be driven mainly by this over-activation of the immune system. “
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The immune system response can also damage organ tissue, which can have serious consequences, he said. For this reason, future therapies for COVID-19 may also need to treat the immune system.
Evans believes it is important to distinguish direct symptoms of COVID-19 from complications, such as kidney failure. Organ failure can occur when a patient is sick with many types of serious infections, not just the coronavirus, he said.
“There are a lot of things that happen to your body when you are so sick. And one of them is certain organs that are very sensitive to blood circulation problems, like the kidneys, your brain. You start to develop what is really a complication of COVID-19. “
“The problem is that all of us in medicine know that it is not uncommon to happen with very sick people in the ICU.”
Even blood clots, which have been reported with COVID-19, can occur in other very ill patients, he said, although other doctors have told Global News that they occur at rates higher in patients with COVID-19.
These complications need to be managed the same whether or not the patient has COVID-19, Evans said.
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So where does that leave a doctor diagnosed? Evans says the symptom list is too long, and as long as there are a limited number of test kits available, doctors should ask more questions to try to determine whether or not a person likely has COVID-19 before getting test.
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For Kindrachuk, the biggest problem is not the long list of possible symptoms, but the fact that patients may have very few symptoms, if any. This makes them very difficult to separate from the rest of the population, or even to treat them.
But more information is good, he thinks, and our knowledge of the virus is growing.
“People are becoming more and more aware of what to look for when they report symptoms. All of these things will continue to evolve over the days, weeks and months as we progress. “
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