positive for Covid-19. It’s not yet certain how Covid-19 triggers anosmia,but remember thos

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Cells in key organs and entire body systems can become inflamed and damaged irreparably, and the risk of deadly blood clots skyrockets. “It’s our own immune system going haywire,” Salata tells Elemental.

Here are most of the known symptoms of Covid-19, followed below by deeper explanations for some of the strangest aspects of the disease.

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Infographic by Elemental; Image source: Getty Images
The strangest cases
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.

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.

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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.
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“We’ve never seen such high levels before,” says Salata, the Case Western physician. One woman recently had levels that were “just not heard of before,” he said. He and his colleagues are finding major clots as well as unusual numbers of smaller clots that can damage the heart, lungs, kidneys, and other organs.

Inflammatory syndrome in children
In late April and early May, a mysterious toxic shock syndrome began showing up in children in various countries, causing at least three deaths in New York. Some cases have been firmly tied to Covid-19 diagnoses; others have not.

The symptoms of pediatric multisystem inflammatory syndrome, as it’s being called, resemble an unrelated syndrome called Kawasaki disease, a leading cause of heart disease in children. Both are marked by high fever, rash, cracked lips, and bloodshot eyes.

It’s not clear yet if Covid-19 and Kawasaki disease are perhaps occurring simultaneously, but Salata thinks the new cases are probably yet another severe immune-system reaction to Covid-19 that only looks like Kawasaki disease. “We don’t know for sure,” Salata says, “but that’s what it really looks like.”

Loss of smell and taste
The loss of smell, called anosmia, can be caused by the common cold, when congestion mucks up nose and nasal passages. Other diseases can trigger anosmia by disrupting or killing the olfactory nerves high in the nasal cavity.

But doctors were surprised earlier this year when people with anosmia and no other symptoms, or only mild symptoms, tested positive for Covid-19. It’s not yet certain how Covid-19 triggers anosmia, but remember those receptor cells that readily receive the coronavirus, present in the lungs and elsewhere? Similar cells exist in the olfactory epithelium, a layer of skin containing the neurons that detect scents.