樵客
讲述亲身经历，感悟天地人生
今天收到美国退协（AARP)的一篇通讯，提到了新冠病毒引起的一些非呼吸道症状。看了这些，应该明白为啥现在不叫肺炎病毒了，为啥有基础病的死亡率高。
文章有点啰嗦，摘重点如下：
Unusual Symptoms of COVID-19 You Need to Know About
Fever, cough and shortness of breath are not the only warning signs of a coronavirus infection, even if they are the most common. In recent weeks a growing number of doctors have documented a handful of otherwise unexpected symptoms in patients with COVID-19, the illness caused by the coronavirus.
Some are reporting red or purple lesions on patients’ hands and feet; others are treating people with diarrhea and severe appetite loss. There are also patients who have lost their sense of taste and smell. These symptoms, strange as they may seem, reinforce what experts around the world have come to realize in recent weeks: The coronavirus is capable of causing more than a respiratory illness; it can launch a full-body attack.
“It takes a while for the full range of symptoms to kind of be known” when you’re dealing with a new virus, explains Lisa Winston, M.D., an epidemiologist and professor of clinical medicine at the University of California, San Francisco. At the start of the U.S. outbreak, the focus was primarily on treating the sickest patients, many of whom experienced classic respiratory symptoms and needed help breathing. “And then, as time went on and people saw more cases, they started to recognize some of the things that are a bit less typical,” Winston says.
‘COVID toes’
If you had asked dermatologist Esther Freeman, M.D., last year what type of skin ailment a future viral pandemic might bring about, she never would have predicted red- and purple-colored toes that swell, burn and itch. But that’s exactly what she and other experts are seeing in patients with coronavirus infections, leading this unusual symptom to be dubbed “COVID toes.”
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Diarrhea, nausea, vomiting and severe appetite loss
COVID-19 is producing symptoms of diarrhea, nausea, vomiting and appetite loss in a number of patients young and old. A recent study out of Stanford University School of Medicine found that nearly one-third of 116 patients infected with the coronavirus reported mild gastrointestinal (GI) symptoms. Earlier reports showed that among roughly 200 patients in China, more than half experienced diarrhea, nausea or vomiting. The Centers for Disease Control and Prevention (CDC) has also acknowledged GI issues on its list of COVID-19 warning signs.
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Loss of taste or smell
On the CDC’s recently expanded list of common COVID-19 symptoms, one newcomer stands out. In addition to fever, chills and a sore throat, the public health agency now recognizes new loss of taste or smell as evidence of a coronavirus infection.
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Neurological effects complicate diagnosis in older victims
This is starting to change, though. Loss of taste and smell, which usually return after the virus runs its course, are two symptoms on a growing list of neurological effects doctors are noting in COVID-19 patients. Other indicators of the illness include dizziness, headache and confusion. In fact, a study in JAMA Neurology found that more than 36 percent of 214 patients in Wuhan, China, experienced neurological symptoms during their bout of COVID-19.
For older adults, in particular, these neurological effects can be just as devastating as the pulmonary impacts of a coronavirus infection, Dong says. They can also be easily overlooked or dismissed as dementia or other diseases common with aging.
Neal Sikka, M.D., an associate professor of emergency medicine at George Washington University in Washington, D.C., says broader coronavirus testing is key to distinguishing COVID-19 patients from those who are suffering from a stroke or experiencing a complication from an underlying health condition.
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Blood clots
Health care professionals are taking note of a troubling trend among coronavirus patients: blood clots. Some studies have found that as many as 30 percent of people with severe cases of COVID-19 experience clotting complications. Clot specialist Alex Spyropoulos, M.D., estimates that the number is even higher. The internist and professor of medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell says that “as many as 40 percent” of patients who are hospitalized because of a coronavirus infection die from blood clots, including micro clots, and the destruction they can cause (heart attack, stroke, lung damage and the like).
“The risk of blood clots are anywhere from about three- to sixfold or greater, more than we’re used to seeing,” Spyropoulos adds. “It has us all in the academic community a little bit befuddled, because it’s one of the most aggressive diseases with respect to blood clots that we’ve ever seen.”
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