Dispelling the myth that COVID-19 is solely a respiratory disease

COVID-19 has now become well-known all over the world. Its debilitating symptoms and high infection rate have quickly created a global storm that has affected everyone in one way or another. The primary symptoms of COVID-19 are not unlike symptoms from a common cold or flu – fever, dry cough, and fatigue.

However, there is a common misconception among many that COVID-19 affects only the respiratory tract (mouth, nose, throat, and lungs). What we have come to realize is that COVID-19 is truly a disease that affects the whole body.

How does COVID-19 attack the whole body?

COVID-19 spreads from an infected person to others through respiratory droplets. These are transmitted when the infected person sneezes, coughs, talks, or sings. When these droplets are released, they may be inhaled or come into direct contact with an uninfected person’s eyes, nose, or mouth.

Once in the body, the virus will replicate and attach itself to a specific type of receptor called the ACE2 receptor. These receptors are present in many cells and tissues around the body, including the lungs, heart, kidneys, liver, blood vessels, brain, and gastrointestinal tract. As a result, the virus can attack many bodily systems and produce a wide array of non-respiratory symptoms.

Symptoms

A large proportion of individuals with COVID-19 do display respiratory symptoms such as cough and breathlessness. However, the vast majority also experience symptoms that are seemingly unrelated.

These symptoms seem to originate in other areas of the body such as the heart, the brain, or muscles. In fact, many will never experience respiratory symptoms. The following symptoms have been documented as common among many individuals with COVID-19:

Respiratory symptoms

The most well-known symptoms of the disease are respiratory in nature. These include dry cough, sore throat, and shortness of breath. Mild respiratory symptoms affect approximately 60% of all people with COVID-19.

Cardiovascular symptoms

Many individuals with COVID-19 will also experience one or more of the following cardiovascular symptoms: chest tightness, chest pain, and heart palpitations/arrhythmias (irregular heartbeat). These symptoms are less common but still occur in a large number of patients.

Generalized / systemic symptoms

Generalized symptoms are felt throughout the entire body. These are by-far the most common symptoms related to COVID-19 and include fever, fatigue, and generalized pain or body aches. The symptoms affect 99%, 70%, and 35% of all COVID-19 patients, respectively.

Neurological symptoms

Neurological symptoms are those affecting the brain and cognitive function. These symptoms are less common; however, some do experience these throughout their symptomatic period. Headache, sleep disturbances, dizziness, loss of concentration, and memory issues are among some of the symptoms reported.

Gastrointestinal symptoms

Gastrointestinal symptoms are common among children and some adults with COVID-19. They include abdominal pain, nausea, diarrhea, and reduced appetite. These symptoms tend to occur early in the symptomatic period and are typically a sign of a mild presentation of the virus.

Musculoskeletal symptoms

Muscle, bone, and joint pain tends to present early and lasts throughout the majority of the symptomatic period. Individuals often complain of muscle soreness, muscle weakness, and generalized muscle fatigue. Early fatigue and muscle pain is often an indicator of viral presence and should indicate testing if exposure is likely.

Ear, nose, and throat symptoms

Comparable to a common 'head cold,' many individuals with the virus will experience symptoms of sneezing, coughing, and mucus/phlegm (27% of patients). It is also common for some individuals to present with tinnitus (ringing in the ear), earaches, dizziness, and a loss of taste or smell.

Psychological symptoms

COVID-19 is without a doubt, scary. The symptoms and the severity of the disease can lead to longer-lasting symptoms of depression, anxiety, and chronic stress. Due to the isolation protocols, people with COVID-19 or those exposed to COVID-19 lack social interaction, the ability to get fresh air, and physical activity. As a result, the disease can be very mentally taxing and can lead to long-term mental health challenges.

Skin symptoms

Although less common, many people complain of rash-like symptoms. These symptoms tend to appear in conjunction with other coronavirus symptoms and often do not stand alone. The most common forms of skin rashes during COVID-19 infection are blister-like rashes and/or swelling with discolouration (COVID toes). Both types of rashes frequently occur on the lower limbs and feet and are typically a sign of a mild presentation of the virus.

Long-term COVID

As this pandemic has evolved, we have learned that some individuals will continue to experience at least one symptom of COVID-19 at 6 months post-illness. In fact, these symptoms are usually non-respiratory and can include: fatigue, anxiety, muscle weakness, depression, joint pain, sleep disturbances, shortness of breath, and brain fog, among others.

Our Post-COVID-19 Rehabilitation Program provides a multidisciplinary approach to COVID-19 rehabilitation and recovery. To learn more about the program and our services or to schedule an appointment with a clinician, visit our services page.

This blog was written by Sydney Holden - a Physiotherapy student at Queen's University.