dives deep into the lungs, or the mucus-encased viruses can slide from the throat into the stomach.

The coronavirus infection begins mainly in the throat, and for many people, it may not go beyond that. But in some cases, the virus dives deep into the lungs, or the mucus-encased viruses can slide from the throat into the stomach. From there, it can spread elsewhere through the entire digestive system and into the bloodstream.

The lungs contain a large concentration of cells that have receptors for SARS-CoV-2, meaning the virus can easily gain entry to the cells, hijacking their genetic machinery in order to reproduce. This process damages or destroys lung cells and triggers the massive immune response, often leading to hospitalization.

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But those same receptor cells exist in blood vessels, in the brain-blood barrier, in the intestines, and in nerve endings, possibly explaining why this coronavirus is able to wreak havoc in so many areas of the body.

Brain swelling and confusion
Fever and headaches can be signs of many illnesses, and they are symptoms of Covid-19, too. Some people have gone to health care facilities in states of confusion or disorientation, sometimes with headaches and fever, sometimes not, only to be diagnosed with Covid-19.

In one case study, brain scans revealed swelling on the brain of a Covid-19 patient, a condition known in other viral infections to cause altered mental status and seizures. One study of 214 Covid-19 patients found 36.4% had neurological symptoms, including dizziness, headaches, impaired consciousness, and seizures.

It’s not yet known if the coronavirus actually infects the brain or if the brain-related symptoms happen because the disease’s impact on the lungs also rob the brain of oxygen.“It is very difficult to separate the two,” says Chethan Rao, MD, a practicing physician and associate professor of neurology and neurosurgery at Baylor College of Medicine Medical Center.

Cytokine storm
When people infected with Covid-19 develop the classic symptom of breathing difficulty, it’s because the coronavirus has infected the lungs and the immune system is at work.

Most patients recover. But if the infection persists, the immune system goes into overdrive, releasing a flood of inflammatory proteins, called cytokines, that contribute to cell death and lead to acute respiratory distress syndrome.

When a cytokine storm strikes, lung tissue can become irreversibly scarred, the lungs fill with fluid, and patients often die. The flood of cytokines also fuels an overload of white blood cells, one of the body’s primary protectors which, in the confusion, begins to attack healthy cells, according to a May 13 study in the journal Frontiers in Public Health. This overaction by the immune system causes hyperinflammation in tissues that can also affect other parts of the body by causing leaky blood vessels, extremely low blood pressure, and a lack of oxygen in the blood.

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Silent hypoxia and Covid pneumonia
Some people with Covid-19 develop dangerously low levels of oxygen in their blood but otherwise don’t feel terribly sick. They might complain of mild flu-like symptoms and perhaps a little shortness of breath or maybe just tiredness.