Scientists can now explain what the novel coronavirus does to the body of those critically-ill from the virus, resulting in almost certain death.
It has now emerged that the disease, which has gone through the globe with such devastation, crippling the health systems of some of the most advanced nations in its wake, affects how red blood cells in the body work in carrying oxygen from the lungs to the rest of the body.
It is now believed that the virus, which has killed some 89,000 people and infected over 1.5 million more, destroys and displaces haemoglobin from red blood cells. This paralyses the cells' ability to get filled with oxygen as the blood is pumped by the heart to the rest of the body.
When this happens, the body goes through the same condition as when it gets carbon monoxide poisoning, explaining why patients in advanced stages of the disease still do not make it out alive even when they are put on ventilators that pump 100 per cent oxygen into their bodies.
At death, doctors have observed that the victims still do not have enough oxygen in their bloodstreams.
The coronavirus has also been noted to cause blood clots on the small blood vessels in the lungs, or by triggering severe inflammation in the lungs causing an accumulation of fluid. This results in a medical condition known as pulmonary edema, making it difficult to breathe.
“This creates a lot of dead space in the lungs, such that the blood flow is not good enough to pick oxygen for the body,” Dr Idris Chikophe, an anaesthesiologist and critical care specialist explained, further indicating that the fluid accumulated in the lungs causes the lungs to be stiff.
This has been noted not just in Kenyan patients that have been in critical condition, but also others globally. Without enough blood in the body, organs start failing one after another. Medical interventions from medics does little to reverse this situation, eventually leading to the patient’s death.
“Acute Respiratory Distress Syndrome (ARDS) is difficult to manage even in the absence of the coronavirus, and it needs the most sophisticated of ventilators with a monitor that can allow the medics to monitor and track the disease and the patient closely,” Dr Chikophe adds.
Globally, the management and survival of critically-ill Covid-19 patients largely depends on early recognition of the patient’s deterioration as well as swift action by a multidisciplinary team of critical care specialists before the virus causes irreparable damage to the lungs.
How the coronavirus causes illness is important in understanding the nature of the disease if scientists and researchers are to come up with treatment options, especially one that would stop the disease from progressing to its severest form.
In laboratory studies, hydroxychloroquine has been seen to stop the novel coronavirus from entering into the human cells, something that scientists believe is due to its alkaline pH.
The dosages of these anti-malarial drugs said to have worked in treating Covid-19 pneumonia have been four to 14 times more than the normal dose used in malaria, with a high risk of heart attacks in those using them.
Previously, chloroquine used in treating viral infections such as Chikungunya had worse outcomes for the patients and was therefore not recommended.
Despite the risk of heart attacks, some patients with severe disease on hydroxychloroquine had a shorter return to normal body temperature and cessation of cough that was maintained for three days, an indication of getting better.
In one of the daily press briefings on Covid-19, Director General of Health Patrick Amoth said at least one critically-ill patient being managed in one of the private hospitals in Kenya was put on hydroxychloroquine as part of the treatment plan with the hope that he would improve.
However, Dr Amoth warned Kenyans that this was not routinely recommended. Dr Daniella Munene, the CEO of the Pharmaceutical Society of Kenya agreed with Amoth, saying the drug was not recommended for use because of the limited data and information around its use in Covid-19 patients.