Dr Anthony Fauci Discusses the Systemic Effects of COVID-19

While coronavirus disease 2019 (COVID-19) is largely a respiratory disease, it is actually a systemic disease that has a wide range of effects and postinfection sequelae that aren’t yet fully known, said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

Transcript

There seems to be a range of symptoms for COVID-19, with some people getting blood clots and neurological symptoms, and then a minority of children are coming down with an autoimmune syndrome. Do you think this will always remain a respiratory disease or do you think it might someday become a systemic disease for some people?

Well, I think it already is a systemic disease for some people—we’re just not recognizing the full implications of the pathogenesis and the clinical manifestations. I mean, I don't think it necessarily is going to evolve to do more systemically, but I think what we'll likely see are more surprises like the multisystem inflammatory disease in children—MIS-C. I think we likely will see as time goes by some postinfection sequelae that we'll only realize as we do good follow up in natural history studies.

I mean, the scope of the seriousness of this infection is extraordinary—from people who get a stuffy nose and a little sore throat and ache, and they get better to people who spend 14 days with a sustained fever and come out wiped out with a postviral dystonia, to people who have serious lung involvement that either puts them in the hospital or creates intubation needs and intensive care…to people who die.

I mean, that range of severity is really in many respects unprecedented. So, I think we still have a lot to learn about the disease of COVID-19.