MILWAUKEE (SPECTRUM NEWS) — In recent months, the scientific world has seen a steady flow of research updating what we know about the novel coronavirus, SARS-CoV-2, and how it affects humans. Because the virus is so new, researchers are still grappling with many questions about its function. And because of the nature of the scientific process, no single study can completely answer those questions. Instead, new research is constantly challenging our understanding of the pandemic.
Here, we explore some recent studies that have shed new light on the virus.
COVID-19 infections might cause lasting heart damage…
Even after patients recover from COVID-19, they may suffer from lingering heart problems, according to a pair of recent studies from German researchers.
As scientists continue to question how, and for how long, the virus actually affects the body, these studies both indicate that the infection goes beyond the respiratory system. Both studies were published last week in the journal JAMA Cardiology.
One of the studies looked at cardiac MRIs from 100 patients who had recovered from COVID-19, compared to others who hadn’t been infected. Of the recovered patients, the researchers found, 78% showed signs of some cardiac involvement, and 60% showed continuing inflammation in the heart.
Most of the patients in the study were middle-aged — the median age was 49 — and two-thirds of them recovered from COVID-19 at home, without requiring hospitalization. But the authors write that the signs of structural changes to the heart, like higher ventricle mass, were common even among those with less severe infections, and that these effects appeared to last after the acute infection symptoms went away.
“The fact that 78% of ‘recovered’ [patients] had evidence of ongoing heart involvement means that the heart is involved in a majority of patients, even if COVID-19 illness does not scream out with the classical heart symptoms,” lead author Valentina Puntmann, told STAT News.
In the second study, researchers looked at cardiac tissue from the autopsies of 39 patients who died of coronavirus. They found high levels of the virus in 24 of these patients’ hearts.
Out of those with virus in their heart tissue, though, 16 patients didn’t show signs of unusual heart inflammation. This raises more questions about how the virus could affect the heart even without causing noticeable symptoms right away.
In any case, scientists say, more study is needed to track the possible long-term effects of COVID-19 infections on heart health.
… And kidneys may face coronavirus effects, too
Researchers are also noting that many coronavirus patients show damage to the kidneys — another effect that could last after the initial infection subsides.
A study from Mount Sinai Hospital System found that 46% of patients hospitalized with COVID-19 showed some type of acute kidney injury, CNBC reports. Most of those patients had no history of kidney problems, and 17% required urgent dialysis as part of their treatment.
The researchers analyzed outcomes for almost 4,000 patients from February to May. For about one-third of the surviving patients, their kidney function after recovery was still lower than before they had contracted the virus.
“The next epidemic will be chronic kidney disease in the U.S. among those who recovered from the coronavirus,” Steven Coca, associate professor of nephrology at Mount Sinai Health System, told CNBC.
Doctors in New York were already sounding the alarm in April about apparent kidney damage as a result of COVID-19. Now, scientists estimate that anywhere between 10 and 50% of severe COVID-19 cases may require dialysis.
Studies like these underscore the growing understanding that the SARS-CoV-2 virus can have wide-reaching effects on the body, stretching far beyond the lungs that we think of as the centerpiece of its attacks. The virus has the power to disrupt tissues in many different areas of your body, and the immune system can end up doing damage if it responds too strongly and starts attacking your own organs.
It will take some time before we can fully see how COVID-19 patients fare months or years after they were first infected. But stories of coronavirus “long haulers” who face lingering and diverse health effects show that recovery is not a simple process in this pandemic.
Half of low-income communities have no ICU beds in their area
Research has long shown that the effects of COVID-19 are not distributed equally across the U.S., as ethnic minorities and poor communities have faced more than their share of cases, hospitalizations, and deaths. A new study, published Monday in the journal Health Affairs, sheds light on one gap in health care in the midst of the pandemic: A lack of access to intensive care.
Researchers from the University of Pennsylvania analyzed ZIP code clusters based on their median incomes and number of ICU beds. The study looked at 4,518 hospitals across the country and their related hospital service areas — the surrounding ZIP codes those hospitals mainly draw from.
What they found was that nearly half of the communities with median incomes under $35,000 had no ICU beds at all within the area. For comparison, only 3% of communities with median incomes over $90,000 lacked ICU beds.
“Because low-income communities face higher infection rates of the virus, as well as a higher prevalence of comorbidities — which increases the risk of death from the disease — the low supply of ICU beds compounds the impact COVID-19 will have on these communities,” study author Genevieve Kanter said in a press release.
The researchers found that these disparities were worse in rural areas compared to cities, and that the Midwest and West had more areas without ICU beds than the Northeast or the South.
Based on the stark differences in ICU availability, researchers wrote that action should be taken to direct funding toward hospitals in underserved areas. The researchers also suggested that health officials rethink the common practice of just directing patients to the nearest hospital, and instead consider sending vulnerable patients to better-resourced facilities.
NIH begins testing antibody treatments
As rapid progress continues in the race to develop a coronavirus vaccine, drug developers are also launching trials for a type of treatment some see as a bridge to immunization.
The National Institutes of Health launched two clinical trials this week to test out an experimental treatment of monoclonal antibodies. These are manufactured in a lab to mimic the unique antibodies that the body uses to fight off a virus, then injected to help the immune system fight back.
In these trials, the NIH is testing an antibody developed by drugmaker Eli Lilly, based on a sample from an early coronavirus patient in Washington state, NBC News reports.
The first trial focuses on patients hospitalized with COVID-19, while the second one will test the treatment on those with mild to moderate cases. One of the goals of this treatment is to address early stages of the disease, since remdesivir and dexamethasone are already shown to be effective in severe cases, NBC reports.
These aren’t the only trials using monoclonal antibodies: Eli Lilly is also beginning to test this treatment on nursing home residents and staff, and other companies, including Regeneron Pharmaceuticals, have been developing their own versions.
Monoclonal antibodies have been used for cancer treatments in the past. They can help prevent infections as well as treat them, but their effects wear off because, unlike vaccines, they are infusing premade antibodies instead of spurring the immune system to make its own, as Al Jazeera reports.
Still, scientists think that if these trials return good results, the antibody treatments could help protect more people while we wait on a vaccine to be finalized and distributed.
“Using an antibody generated by the immune system of a recovered COVID-19 patient gives us a jump start on finding a safe and effective therapeutic,” infectious disease expert Anthony Fauci said in a NIH press release. “Investigating a variety of different therapeutics, including monoclonal antibodies, will help ensure that we advance towards an effective treatment for people suffering from COVID-19 disease as quickly as possible.”