Respiratory, organ failure and heart attacks responsible for Covid-19 deaths: Study
Skip to main content
  • Home
  • Economy
  • Stocks
  • Analysis
  • World+Biz
  • Sports
  • Splash
  • Features
  • Videos
  • Long Read
  • Games
  • Epaper
  • More
    • COVID-19
    • Bangladesh
    • Infograph
    • Interviews
    • Offbeat
    • Thoughts
    • Podcast
    • Quiz
    • Tech
    • Subscribe
    • Archive
    • Trial By Trivia
    • Magazine
    • Supplement
  • বাংলা
The Business Standard
FRIDAY, MAY 20, 2022
FRIDAY, MAY 20, 2022
  • Home
  • Economy
  • Stocks
  • Analysis
  • World+Biz
  • Sports
  • Splash
  • Features
  • Videos
  • Long Read
  • Games
  • Epaper
  • More
    • COVID-19
    • Bangladesh
    • Infograph
    • Interviews
    • Offbeat
    • Thoughts
    • Podcast
    • Quiz
    • Tech
    • Subscribe
    • Archive
    • Trial By Trivia
    • Magazine
    • Supplement
  • বাংলা
Respiratory, organ failure and heart attacks responsible for Covid-19 deaths: Study

Health

TBS Report
12 April, 2020, 10:30 am
Last modified: 12 April, 2020, 11:18 am

Related News

  • Indonesia to drop outdoor mask mandate as Covid-19 infections drop
  • WHO: Covid-19 falling everywhere, except Americas and Africa
  • N Korea reports first Covid-19 outbreak, orders lockdown
  • Social Welfare Minister Nuruzzaman being flown to Dhaka after heart attack 
  • 34 volunteers chose to get covid. Here’s what scientists learned

Respiratory, organ failure and heart attacks responsible for Covid-19 deaths: Study

The difference between Covid-19 and normal pneumonia is lack of immunity against the new virus and greater severity of infection

TBS Report
12 April, 2020, 10:30 am
Last modified: 12 April, 2020, 11:18 am
File Photo: Reuters
File Photo: Reuters

People with the novel coronavirus infection may die of a heart attack, respiratory failure, multiple organ failure or septic shock, but the cause of death is irrefutably for coronavirus, according to some scientists and clinisiscs, debunking attempts by some states to attribute fatalities to other reasons.

"Coronavirus or Covid-19 infected people killed by respiratory failure and cardiac arrest, just like any other severe pneumonia. The difference is lack of immunity against the new virus and greater severity of infection," said Dr Anurag Agrawal, director of the Institute of Genomics and Integrative Biology, New Delhi, reported Hindustan Times.

Earlier this week, a 78-year-old Italian woman in Gurugram's Medanta hospital was classified as a Covid-19 fatality after she died due to a heart attack, days after test results showed that she had managed to clear the Sars-Cov-2 infection for which she had been hospitalised.

"She died of multi-organ failure following a cardiac arrest, her kidney function was deranged when she was admitted to the hospital, and she was close to 80 years old; the mortality rate in such people with Sars-Cov-2 infection is close to 15%. The cause of death was Covid-19 because persistent infection is what led to the multi-organ failure," said Dr Yatin Mehta, chairman, anaestheology and critical care, Medata-The Medicity. The woman died on Thursday while 13 other Italians who were in her group recovered and were discharged form hospital two weeks ago.

Data from several countries that have been hit hard by the pandemic shows one in five people who contract Covid-19 become very ill. Chronic lung disease, cardiovascular disease and diabetes are the top three risk factors associated with potentially life-threatening complications.

In China, nearly all of the fatalities among 44,672 who were specifically studied ,were people who had such underlying conditions, according to what is the largest study yet of Covid-19 patients, published in the Journal of the American Medical Association (JAMA).

In the US, 78% of Covid-19 patients in intensive care units (ICUs) and 71% of those hospitalised had one or more reported underlying health conditions, compared to 27% among those who did not need hospitalisation, according to an analysis of records of hospitalised patients between February 12 and March 28 by the US Centers for Disease Control, which called the findings consistent with what has been seen in China and Italy, one of the other major hot spots of the disease.

Vulnerable heart

According to one of the studies from Wuhan, the ground zero of the pandemic, one in five patients showed signs of heart damage.

Cardiovascular conditions are often what kill patients, with "thromboembolic disease, hypercytokinaemia, secondary sepsis, hypovolaemia, and renal complications" being a toxic combination that doctors treating Covid-19 patients have to manage, according to a comment by Richard Horton, editor-in-chief of The Lancet, on April 11.

Horton mentions cardiac troponin I as a reliable indicator of heart damage in some of the fatalities. A thromboembolic disease refers to clots in blood vessels, hypercytokinaemia is a strong, potentially fatal immune reaction; while hypovolaemia refers to low levels of plasma, which is a critical component in the blood that contains antibodies and clotting factors.

Indian experts said heart damage could be explained by several reasons. "This could be because of causes ranging from acute cor pulmonale (heart working harder to pump blood as oxygen levels fall because of lung tissue freezing); heart muscles suffering hypoxic damage, leading to depressed function, and arrthythmias (irregular heartbeat), viral myocarditis (inflammation after virus directly invades heart cells); and possible rise in thrombosis (blood clots)," said Dr K Srinath Reddy, president, Public Health Foundation of India, and former head of cardiology at All India Institute of Medical Sciences (AIIMS), New Delhi.

Several other viral infections are known to disrupt blood flow to the heart, leading to irregular heartbeat and heart failure. During influenza outbreaks, more people die from heart complications than from pneumonia, according to a study in the journal JAMA Cardiology.

A 2018 study in the New England Journal of Medicine found the risk of heart attacks rising almost six-fold when a person has flu infection.

Lung onslaught

Smokers and people with COPD have also been identified as being at higher risk of infection and severe disease because their lungs and lower respiratory tract have cells showing a higher "expression" of ACE2, the portion of a cell through which the Sars-Cov-2 invades it, according to a study by the European Respiratory Journal. In mice, ACE2 has been shown to protect animals from severe lung injury related to breathing and sepsis.

"There is an increased ACE2 expression in airways of current (but not former) smokers and those with COPD... while the upregulation of ACE2 may be useful in protecting the host against acute lung injury, it predisposes them to increased risk of coronavirus infections, which uses this receptor to gain entrance into epithelial cells. This may in part explain the increased risk of viral respiratory tract infection in active smokers and virus-related exacerbations in those with COPD," said the study. Upregulation refers to a cell increasing the quantity of a cellular component, such as RNA or protein, in response to an external stimulus, such as a virus.

Protein connection

ACE2, or angiotensin-converting enzyme 2 (ACE2), is increasingly posing a challenge. ACE2 is a surface protein that is present at several key locations in the body: it covers cells in upper and lower respiratory tract, heart and the gastrointestinal tract, and plays a role in blood pressure, cardiac function and immune regulation. Targeting this protein is what makes the Sars-Cov-2 insidious in how it infects a body.

In response to this, the body mounts an immune attack by releasing small proteins called cytokines into the blood. But with the virus knocking ACE2 out, the immune response can go haywire, causing a cytokine storm that can lead to tissue and organ damage.

People with high blood pressure or heart disease are also prescribed ACE inhibitors or angiotensin receptor blockers (ARBs), which can inhibit ACE-2 action.

"The current consensus is that if people are already taking these medications, they should stay on them but they must consult their physicians. Depending on the severity of the infection and the clinical status of the patient, the medication may need to be modified," said Dr Reddy. 

Top News

Coronavirus / Heart attack / pneumonia / Deaths

Comments

While most comments will be posted if they are on-topic and not abusive, moderation decisions are subjective. Published comments are readers’ own views and The Business Standard does not endorse any of the readers’ comments.

Top Stories

  • What needs to be done now?
    What needs to be done now?
  • File photo of Dr Debapriya Bhattacharya. Picture: CPD
    Fiscal consolidation is a way out
  • Safety net needs to be expanded by minimising corruption 
    Safety net needs to be expanded by minimising corruption 

MOST VIEWED

  • Rangpur has the highest number of obese people, Khulna has the lowest: Study
    Rangpur has the highest number of obese people, Khulna has the lowest: Study
  • 35 people test positive for Covid-19 in 24 hours
    35 people test positive for Covid-19 in 24 hours
  • Representational image. Picture: Pixabay.
    Indian eye experts to train surgeons in Bangladesh
  • Representational Photo
    Antibiotic packaging to be flagged red
  • With the ongoing pandemic exposing the inadequacies of our healthcare system, we must now formulate long-term solutions to protect ourselves from any future repercussions of the virus, as well as any other situation that may arise. hoto: Mumit M/TBS
    Building hospitals alone cannot prevent noncommunicable diseases: NHFB president
  • Photo: PR
    NCDC Programme marks ‘World Hypertension Day’

Related News

  • Indonesia to drop outdoor mask mandate as Covid-19 infections drop
  • WHO: Covid-19 falling everywhere, except Americas and Africa
  • N Korea reports first Covid-19 outbreak, orders lockdown
  • Social Welfare Minister Nuruzzaman being flown to Dhaka after heart attack 
  • 34 volunteers chose to get covid. Here’s what scientists learned

Features

Sketch: TBS

'Food inflation is an unavoidable consequence of currency devaluation'

17h | Interviews
The open-browser-tabs question also tells an interviewer how much of an internet native the job applicant might be. Photo: Noor-a-Alam

The best question to ask a job applicant

17h | Pursuit
Illustration: TBS

Ugly business: Politics in workplace

16h | Pursuit
Illustration: TBS

‘Do you have insurance?’: Life of a life insurance agent

19h | Panorama

More Videos from TBS

Putin's strategies to face Nato

Putin's strategies to face Nato

6h | Videos
How many countries have nuclear weapons and how many are there?

How many countries have nuclear weapons and how many are there?

6h | Videos
Dengue fever is rising, so beware

Dengue fever is rising, so beware

6h | Videos
How a university teacher and PHD holder become farmer

How a university teacher and PHD holder become farmer

10h | Videos

Most Read

1
Tk100 for bike, Tk2,400 for bus to cross Padma Bridge
Bangladesh

Tk100 for bike, Tk2,400 for bus to cross Padma Bridge

2
Representative Photo: Pixabay.
Bangladesh

Microplastics found in 5 local sugar brands

3
Mushfiq Mobarak. Photo: Noor-A-Alam
Panorama

Meet the Yale professor who anchors his research in Bangladesh and scales up interventions globally

4
A packet of US five-dollar bills is inspected at the Bureau of Engraving and Printing in Washington March 26, 2015. REUTERS/Gary Cameron
Banking

Dollar hits Tk100 mark in open market

5
The story of Bangladesh becoming a major bicycle exporter
Industry

The story of Bangladesh becoming a major bicycle exporter

6
PK Halder: How a scamster rose from humble beginnings to a Tk11,000cr empire
Crime

PK Halder: How a scamster rose from humble beginnings to a Tk11,000cr empire

The Business Standard
Top
  • Home
  • Entertainment
  • Sports
  • About Us
  • Bangladesh
  • International
  • Privacy Policy
  • Comment Policy
  • Contact Us
  • Economy
  • Sitemap
  • RSS

Contact Us

The Business Standard

Main Office -4/A, Eskaton Garden, Dhaka- 1000

Phone: +8801847 416158 - 59

Send Opinion articles to - oped.tbs@gmail.com

For advertisement- sales@tbsnews.net

Copyright © 2022 THE BUSINESS STANDARD All rights reserved. Technical Partner: RSI Lab