when coven 19 first started popping up
in the news
its symptoms were described as a fever a
dry cough and sometimes shortness of
breath
but now researchers have compiled a more
exhaustive list
including skin problems a loss of smell
or taste and even
neurological symptoms it can harm the
lungs the kidneys and even the
circulatory system
and what about those purple covered toes
when covid19 began i think it was
surreal for all of us
and as a physician me and my colleagues
around me and really every specialty
recognized
this was a special time in our careers
where we had an opportunity to
potentially make more of a difference
in the world than we may ever have in
our entire lives
dr fernandez is one of the many doctors
and researchers focusing on the symptoms
or manifestations of covid19
to better understand what exactly we're
dealing with my name is dr
anthony fernandez i am a dermatologist
and a dermatopathologist at the
cleveland clinic
in cleveland ohio every virus is unique
in three-dimensional structure and
because of that activates the immune
system
in different ways and that creates
different manifestations
collecting information about the array
of symptoms associated with covid is a
good way for experts to understand
what exactly the virus is doing in the
human body and how it's moving around
when a patient is first infected with
sars cov2 the virus that causes
covid19 it's usually inhaled
and it begins to infect cells in the
respiratory tract
and produces more and more virus this is
why we wear masks
duh from here the virus can work its way
into tiny air sacs in the lungs
these air sacs are filled with a protein
receptor called ace2 and this is what
the virus uses to break into cells where
it can replicate and spread
another group of cells that produces
ace2 is the cells that line blood
vessels throughout the body
and because of this the virus can invade
those too this can cause the blood
vessels to leak and the blood to clot
that virus is do most viral infections
eventually
involve that virus getting into the
bloodstream and circulating
throughout the body blood clots can lead
to heart attacks strokes and tissue
damage
so this is where those cardiovascular
and neurological symptoms can come
into play the virus can also interfere
with your nervous system but this needs
more research
there are some clues that the virus
infects nasal cells potentially causing
a block in how these cells communicate
with the brain
hence the loss of smell and taste that
some patients experience
and of course there's a reason we wanted
to talk to a dermatologist
dermatopathologist in the skin it still
seems to be
a little bit unclear but it may infect
the blood vessel cells
that traffic through the skin or it may
be
that the immune system cells in the
blood
are simply activated by the presence of
that virus
and emits signals that then activate
the immune system cells that are in the
skin you may have heard of those
infamous covid toes
red or purple itchy bumps on the toes
and sometimes the fingers
one of the arguments for why patients
may get these covetous lesions if it is
specific to covid19
is that these young patients have very
well functioning immune systems and
mount a very robust response against
that virus as soon as it enters the body
and eliminate it effectively and rapidly
before it can reproduce to high numbers
in the body
so the rash might be an indicator of
really high immune system activity
but then again these toe troubles might
have nothing to do with the virus at all
and so another theory is that it's
really lifestyle changes during
quarantine
individuals walking around bare feet
around their house or or
spending their days doing different
activities than they otherwise
normally would is really what is
precipitating more cases
of these so-called covetous so while
coveted toes are still a bit of a
mystery
the skin matters when it comes to
understanding covet 19 because it's such
a vital part of the immune system
if you think about your body as a castle
then you can think about your skin as
that big wall around the castle
that is put there to serve as
a main barrier to keep all the bad
things in the outside world
out and your body recognizes the
importance of the skin
and in defending that wall and so it
invests
a lot of energy in lining that wall with
troops
which represent immune system cells many
things can
cause those cells to become activated
invading
things from the outside world can
immediately cause those cells to become
activated as they try to defend
that wall that barrier from anything
getting inside of it
but also those immune system cells can
hear signals
from within the body the skin can be a
hint at how a disease will progress
with kovid there is a particular rash
that dermatologists are studying to see
if it might indicate the internal blood
clotting that we talked about earlier
the other manifestation that we have
seen especially in
severely ill patients with covid19
typically patients who are intubated who
need a mechanical ventilator to breathe
for them
because of the degree of inflammation in
their lungs is
what we call retiform purpura or a
violacious rash
but what we recognize as being a clue
that there is
some vascular insult going on underneath
the skin
either clotting in the blood vessels or
inflammation around the blood vessels
which we call vasculitis and as for side
effects of the vaccine
one of the most common manifestations in
the skin
has now been dubbed covet arm and
essentially represents
a large oval to round pink to red
rash a raised area called a plaque on
the arm
the lateral arm at the injection site
it's usually asymptomatic
and it really has no consequence so it
does not need to be treated
it is not an indication that the vaccine
will not be effective
or is going to cause some other problem
in the patient
it probably simply represents activation
of the immune system
in that area of the body
you