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I got a bad headache last time I had the flu. I even had to take paracetamol.
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This virus is uncommonly indiscriminate in how many organ systems it damages. This may be due to its ability to deoxygenate a patient, systemic auto-immune response, systemic inflammation or vasculitis in organs, stroke like events with blood clots in multiple events, etc. What a beast of a virus!
Other coronaviruses can infect the nervous system. In fact, there were papers out in 2018 describing neural infections by "human coronavirus".

Cytokine storms and their associated effects (like clotting ,etc.) are also present with other viral infections, like with the original Spanish Flu H1N1 strain (during the infamous "second wave").

"Regular" pneumonia can severely weaken you for months or a year, even if you have antibiotics.

This virus is absolutely not a magic virus. It is novel, but it is still a coronavirus.

The problems could be related with the fact that pangolins have an unique and strange immune system. Reduced in comparison with most other mammals (but I'm speculating...)
This virus definitely looks as if it had ample time to adapt to human host. Just many early cases were probably undetected or misattributed.
Immune systems are fairly differentiated across species, even for common mechanisms. Source: I worked from 2009 to 2011 in a project aiming at reconstructing part of these mechanisms in certain immune cells, and the differences between human and mice, where some models were made, were significant.
My frustration with articles like this is that they fail to point this out adequately. These problems are significant on their own, but they do not necessarily warrant this virus being treated differently from others.

The things that warrant the separate treatment are still the high death rate, high hospitalization rate, and potential for large spread across a population with little existing immunity.

Let me get this right... You significantly reduce the oxygen levels in a bunch of old people's brains for a month and they develop neurological issues? That is a remarkable finding. I would never have guessed.
Something to consider and also something not discussed in the article: it's very possible that sars-cov-2 can directly infect neurons directly considering the expression of ace2 receptors across them.

https://www.biorxiv.org/content/10.1101/2020.04.07.030650v1

So beyond the risk of kidney failure stemming from damaged cardiovascular tissue debris jamming up nephrons (as well as potential direct kidney infection by the virus) and beyond the risk of stroke from the uptick of platelets and the redistribution of the marrow cells which produce them across the body (somehow. I can't find the research that identified this), there's also the risk that the virus is actually directly attacking neurons.

Not really a surprise considering how common ACE2 receptors are.

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I'm not a doctor. Not an epidemiologist either. Please fact-check me if I'm wrong.

That paper answers my first question, does neurological tissue have ACE2 receptors. The damage can also be a side-effect of oxygen deprivation. The existence of ACE2 receptors in the brain begs the question of how the SARV-CoV-2 virus crosses the blood-brain barrier. IIRC, dental surgery has been correlated to pathogens crossing the barrier. I wonder if that is a key factor here as well.
Note that similar effects have been observed with other critical illnesses: https://www.nejm.org/doi/full/10.1056/NEJMoa1301372
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Indeed, and as someone who is familiar with the condition often described as "we can't exactly work out what it is but I guess you could all it CFS/ME [1]", this is often linked to common viral infections including Epstein-Barr and cytomegalovirus.

CFS/ME sufferers often exhibit some of the neurological symptoms mentioned in the article (though not the more extreme/terminal ones like stroke).

Lyme disease sufferers also often exhibit these kinds of symptoms to some degree, which is why, in the absence of serology evidence, it can be difficult to distinguish from CFS/ME.

[1] https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome

I just want to point out that in the US at least, infections are often treated with flouroquinolones and the side effects can result in fibro/cfs diagnosis. Symptoms can show up even at 12 months. I have met numerous people over the years, who were given cipro/levaquin just in case while they were waiting for blood test results and started having odd neurological symptoms lasting months or years. Later results turned out to be normal and no infection.

The medical community has been failing most of these people and I am among them. Many report symptoms during their course and doctors rarely report the issue to the FDA. I have been to Mayo and other popular hospital systems and honestly sometimes I feel like there is a big conspiracy to protect the drug, it seems quite surreal.

In Europe during EMA panel a few doctors spoke out and mentioned the issues their patients are dealing with. Some patients also described their symptoms: neurological issues, widespread muscle/tendon pain, insomnia. It sounds very similar to CFS/Fibro.

People seem to have a naïve view of what “cured” means: someone “gets sick”, is treated, and then returns to the status quo ante. Thus there is little concern about catching the disease (or any disease) when you are not in an “at risk” group.

But hospital discharge just means the treatment you get stops being worth the time/money. Ideally you finish convalescing at home. But any consequential damage isn’t ignored, as if you just had had a dented panel replaced on your car.

Once I understood this error some of the discussion about dealing with the virus made sense.

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Did you see the parts of the article where they say that the most severe, “consequential damage” is predominantly found in the elderly and most severely ill? You’re implying that people who have mild cases (>99% of all cases; remember: over 40% cases are so mild that they’re considered “asymptomatic”, and for every one case we detect, 10-20 others never even bother to be tested!) have some kind of neurological damage. That isn’t what this article says.

Aside from a very tiny group who had strokes (again, mostly elderly), this research shows predominantly mild symptoms that (e.g. headache, insomnia), which would not be expected to persist.

If you read past the headline, you will see that even this article makes it clear that the vast majority of patients have minimal symptoms:

” Another large-scale study, this one with 909 coronavirus patients in Madrid, showed that 90% of cases simultaneously experienced changes to, or the loss of, the sense of smell and taste. In most of these cases, these changes were the only clinical expression of coronavirus or were accompanied by other minor symptoms.”

The headline was indeed more inflammatory than the facts of the article. It seems like the media wants people to panic.
Maybe the media wants to inform people that they should wear a mask.
> The headline was indeed more inflammatory than the facts of the article. It seems like the media wants people to panic.

I wouldn't conflate a clickbait headline on a single article by a single website into a widespread conspiracy by "the media" to spread panic.

The incentives to write scary articles are clear. No secret cabal required.
It's not a conspiracy, but anyone that has worked in or with a newsroom will tell you that panic and fear sell newspapers (or clicks). Reporters get judged on article engagement and being humans, they optimize for the metric that they get judged on.
The phrase "If it bleeds it leads" was coined in 1989. Seems apt.
I can't speak for the article here, but at least some local media in my country wants to generate clicks and views, so the more horrifying the headline (but also the article contents), the better.

See the recent matter on antibody decline: few if any got it right (although it can mean a waning immune response it is not enough to tell if it is happening).

A small percentage change in the output of knowledge workers would have an outsized effect on the overall economy. This kind of data is as dramatic as the title suggests. We can’t afford to poke this bear.
>>A small percentage change in the output of knowledge workers would have an outsized effect on the overall economy.

Especially in the US, where healthcare bills are the number one reason for personal bankruptcies (66.5%).

I don't know why people are downvoting you. The hacker news karen-signal has been activated I guess.
The problem is that there have been no large scale studies on those who were released from the hospital nor on those who were deemed 'not sick enough' to be hospitalized in the first place.

Hopefully TX, FL, AZ are used as a basis for some study as so many of those in the hospital now are young (ie, under 40).

No, but these small scale studies point to prolonged complications only in those who were the most elderly and/or the most severely sick.
> You’re implying that people who have mild cases (>99% of all cases; remember: over 40% cases are so mild

The death rate alone is ~0.8%. There are another few percent that require hospitalization. The >99% of covid cases are not mild.

Are you talking about confirmed cases here?
I am talking about serological studies in Italy and South Korea. For confirmed cases death rates are 5%, but that’s because a bunch of people are positive and untested (many of them asymptomatic).

One thing to remember that at any one time there might be 99% not serious, but that includes a bunch of people who are recovering from serious or who will degrade to serious. Over the full cycle of the disease a much larger percentage will have a serious state. Close to 1% will die.

At the same time, being in prone position, getting steroids, etc really do seem to increase survival so maybe the death rate now is lower.

"The death rate alone is ~0.8%."

It is not.

The current estimates for IFR run from ~0.2-0.7%. The current best estimate of IFR from the CDC is 0.65%, with the deaths skewed heavily to the elderly and infirm.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

CDC estimate, just 1 week ago, before this catastrophic correction, was 0.25% or something similar. MONTHS ago we had the results from a huge Spanish study that put the mortality rate at around 1% and it was perfectly coherent with the Italian and New York studies. Why should we believe their current estimate when we have multiple results that actually give us a pretty high confidence of the actual mortality rate instead of looking at what seem like completely random figures?
Stop spreading misinformation in here please. There is no way that >99% cases are mild when the current estimates put the actual fatality rate to around 1%. You are just repeating Trump lies, and lies are not well accepted here.
Not to mention it'll be years or perhaps decades before we completely understand the lasting effects of infection. Many survivors might be looking at something like post-polio syndrome or worse.

And we know even less about the long-term epigenetic effects. What's the effect on childhood development? Fetal development in the case of infection during pregnancy? Who knows.

The other thing that make combating it hard is it has a relatively low death rate, especially for people without preexisting conditions, when compared to big, scary viruses like Ebola, and a lot of cases have relatively minor symptoms.

If death rates were 1/10 of what they are (which really means a less severe virus overall), there's a good chance most countries would have let it run its course.

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....most of which are mild, and which accompany any virus:

”According to Segura, who co-authored the study, the most common symptoms experienced by coronavirus patients were myalgia, headaches and dizziness.”

And the truly killer quote:

”Another large-scale study...showed that 90% of cases simultaneously experienced changes to, or the loss of, the sense of smell and taste. In most of these cases, these changes were the only clinical expression of coronavirus or were accompanied by other minor symptoms.”

There is a reason we get so concerned when there is evidence of CNS infection. It's not as simple as "loss of smell."
The reason you “get so concerned” is because you are spreading fear, and you systematically attempt to censor anyone who points out that your fear isn’t supported by evidence.
COVID-19 fear entered moral conviction territory long ago.

It's useless to argue the numbers or even suggest the possibility of evidence that tempers the doomsday fear.

It's like arguing against the religious.

> It's useless to argue the numbers

With very few exceptions, those "arguing the numbers" present a systematically biased and intentionally deceptive view that this virus is not dangerous and systematically hamper the collective action necessary to slow its spread. Instead of merely presenting a "balanced view", it's a rather irresponsible level of misinformation by...let's be frank...rather uninformed armchair epidemiologists who often have zero background in medicine, zero background in infectious diseases, and hardly any science background at all.

The virus is killing and maiming people worldwide. It's highly infectious. Basic shit like wearing masks is now political.

I don't mean to unload on you, because you are making a meta point, but seriously, most people arguing "the numbers" are completely full of shit. Listen to experts on infectious diseases, and shun internet crackheads, no matter what research papers they think they understand, and don't.

You should take this seriously because people are actually dying.

>Basic shit like wearing masks is now political.

Masks became political the moment the CDC, WHO, and US Surgeon General lied to the public by telling them that masks don't help and would even be worse than not wearing a mask. The world's leading experts made it political, don't blame nobodies with no power for that.

>You should take this seriously because people are actually dying.

"People are actually dying" isn't the adult conversation. The adult conversation acknowledges that there may never be a vaccine or even a good treatment for this disease. Many countries have their infection "under control" but this is only because of fairly draconian policies which cannot be implemented forever. Once the draconian policies are pulled back, the infection will hit them again because there is no herd immunity and no vaccine. The adults in the room are having a discussion that balances the understanding that there is a dangerous disease out there with the further understanding that draconian measures cannot be permanent and at some point the world may just have to deal with the consequences of returning to normalish life. The only question that matters is "How long do we wait?" and that question is not primarily an epidemiological one. For you personally, the answer to that question may be "forever," but it seems pretty clear that "forever" is not an answer most people will accept.

Bang on. Around the time the US Govt issued the pandemic warning I was scrambling to get the information I needed to make adequate decisions about the safety of the public works crew I was managing. The COO of a local hospital was on the public works committee so I asked her what to do regarding PPE. Her response was honest: "Try to get some, but if you don't already have it, you probably won't be able to get any." If you remember, around that time we were hoarding toilet paper. Then I called the infectious disease specialist at our local health department and asked the same, what about PPE? The nice, polite lady told me masks were useless and depictions of Asians wearing masks were showing people who were concerned with the air pollution. So from the get-go there has been plenty of confusion coming through official channels.
Yeah, the entire US response has been completely confused and deeply incompetent. But I place blame at where the buck is supposed to stop. At the president's desk. Literally the first two words he ever used to describe the virus were "Democrat hoax" which are right in line with his basic approach to everything: politicize, divide, deny, and lie.

It wasn't some innocent misstep. He's sticking with the division and stoking hatred and reality denial....aww crap I am ranting.

Suffice is to say that CDC can be held culpable for some screwups but leadership from the President is something the country desperately needs.

Could you stop with the "adult conversation" bullshit? This patronizing tone is not fit for Hacker News. Also it ironically makes you sound like a child who wants to show off how "adult-like" they are.
What is the "tone" of literally accusing posters of not caring if people are dying?
Appealing to your humanity.
Dismissing people with nuanced views as being inhumane is a personal attack and a violation of the rules here.
> Masks became political the moment the CDC, WHO, and US Surgeon General

Ah, I see you take the Trumpian line of "it's everybody else's fault except me!". It became political in your country because the dozy muppet you elected as president can't actually deal with anything.

> "People are actually dying" isn't the adult conversation.

It's the reality on the ground. Other countries are gradually opening up their "draconian measures" and are managing to contain the virus. If you can't do that, it's your own failure.

>Ah, I see you take the Trumpian line of "it's everybody else's fault except me!". It became political in your country because the dozy muppet you elected as president can't actually deal with anything.

I'm pro-mask and anti-Trump. Let's be clear. The world's leading experts gave us mask advice that they knew was a lie and likely lead to the deaths of tens of thousands additional people. No one has been fired. No one has had to resign in disgrace. Yes, I'm more upset at them than I am at some rando at the grocery store who doesn't want to wear a mask.

>It's the reality on the ground. Other countries are gradually opening up their "draconian measures" and are managing to contain the virus. If you can't do that, it's your own failure.

If you don't have a definitive answer to what is the maximum time for how long you'd continue the draconian measures, you're not even in the conversation.

Our strategy from very early on was to flatten the curve so our hospitals weren't overrun. We succeeded, our hospitals have not been overrun. We're building herd immunity at a faster rate than other countries. It's totally fair to criticize that, but not without the context of the fact that other countries will eventually have to deal with this by building their own herd immunity. It appears they are choosing to spread that process out over a longer period of time. That's a very reasonable strategy also. Discussing different strategies is totally fair, but if all you can say is insult people by saying "You're not taking death seriously!" you're not participating in the conversation.

You carry on the "draconian measures" until the virus is unable to spread and dies out. It's not magic. It spreads through human contact. Reduce contact you reduce transmission.

You are in the same camp as Trump because you're spouting clueless crap as though it's authoritative.

I'm perfectly happy to be "not participating in the conversation" because your conversation is moronic bullshit.

>You carry on the "draconian measures" until the virus is unable to spread and dies out. It's not magic. It spreads through human contact. Reduce contact you reduce transmission.

What does this look like in practice? Do you intend to keep every national border closed until the entire planet has eradicated the disease? How long do you expect that to take? Do you believe this is sustainable for 5 years? What about 20 years? Will you also be keeping the schools closed during this time?

I think there are some countries that have no more cases, so each country would have managed same thing the issue can be solved, so a solution is to isolate only the countries that have a high risk.
Does your statement change if I personally know several people who are ill and a few who have died? I have first hand experience. Do you? Yes, I am afraid, but that fear is backed by empirical evidence and my study of the science of this disease, not the media. You should be afraid as well.
I personally only know of one person that has tested positive for Covid-19 and she recovered fully after about two weeks. Can you tell us more about the people you know that died due to Covid-19? General demographic info, like sex, age, that type of thing.
I know 2 people with older relatives who died. My wife's grandmother caught it in a nursing home and remained asymptomatic the best we could tell (she has dementia). Other people around her in the nursing did die from the virus.

I know of multiple people in their 20s-30s-40s who have said it's the worst sickness they have ever felt. Some others who were really sick for a day or 2 and now seem fine.

I'm not a doomsday person, but it's something I'd like to avoid rolling the dice on (and I do have fear of older relatives catching it). Then there are the possible long term health effects still unknown. Unfortunately for whatever reason people have to be scared into taking the simple, basic precautions.

I cannot share details due to HIPAA, other than one was not in an at risk group. The other was. Additionally, some individuals who have gotten ill have "recovered" as in they aren't going to the doctor/hospital, but still cannot walk long distances or think clearly months later.

The thing about the disease is that it attacks some people much much more severely than others. We do not know why yet, but I'm positive that we'll eventually find out there are biological reasons (blood type, genetics, Vit D levels, etc).

My good friend is a healthy & fit 24-yr old male. He bikes about 60-80miles every week, doesn't smoke or drink (ever), has no medical conditions, and takes no medication. He had a mild case a few weeks ago— tested positive for antibodies, felt like a really nasty flu plus trouble breathing but felt mostly better in 2 weeks. He is having persistent symptoms that are really affecting his day-to-day life. He experiences serious fatigue about two days a week, to the point where it's difficult to work, and has occasional brain fog.

It's really scary, I'm worried for him. And now I really don't want to get it.

Just throwing this out there: Persistent symptoms are correlated with low vitamin D levels which are common.
Coworker died. Was male, 38, no comorbidities. Left two small kids behind who probably won't remember him.
No. Facts are facts.
". . . isn't supported by evidence."

This thread is _literally_ about the gold-standard scientific evidence (gathered by Spanish doctors) about how COVID is attacking the nervous system.

COVID-19 patients may have neurological symptoms, but that doesn't mean that SARS-CoV-2 directly attacks the CNS. As noted recently, most neurological symptoms associated with COVID-19 can be explained by vasculopathies and coagulopathies rather than the direct infection of neurons [1]. Such results are consistent with findings from autopsies. In contrast, neither of the papers mentioned in the linked article provide any evidence that SARS-CoV-2 is "directly attacking the brain".

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328585/

The comment I made was _literally_ just two quotes from the gold-standard spanish doctors.

Such evidence is good when it supoorts your narrative, and bad when it doesn’t. Think about that for a second.

It's worthwhile pointing out that being "censored" and being a moron feel subjectively pretty similar at first blush, especially without some introspection. With no introspection, the odds are stacked heavily to one side on that.
It seems more like you're trying to censor people talking about the scientific details and facts around covid-19.
Covid is only the single biggest cause of death in the US for the past few months, so safe!
No, the reason you “get so concerned” is because you are scared, and intent on spreading fear to others.

You downvote factual comments simply because you don’t agree with them, and don’t want others to see them.

My family got corona positive last month, around the same time my brother started having some neurological issues. The doctors after seeing the MRI did not detect any issues. The same was confirmed by other radiologists and multiple other MRI scans over the month. Yet he faces these issues: nausea,headache,confusion,weakness,ataxia (unsteady walk) sensory changes, including numbness or tingling,trouble with vision (one eye doesn't move / change focus as much as quickly as the other eye ). All these issues point to a brain infection yet none is detected.
Did your brother have any underlying health issues prior to contracting covid-19? Incl family history of any of these disorders, obesity, diabetes, etc?
No disorders, No family history of diseases except diabetes in a few older ones. All of us got over corona with just a little fever except him. Well we cant even say with confidence what is happening with him is due to corona, it could be two different diseases coinciding at the same time.
I'm no doctor, but during this period I've experienced anxiety, and some of those symptoms match physical symptoms of anxiety. Nausea, headache, difficulty breathing, tight chest and neck (hell i've noticed even the fucking tongue was tight being pressed against the teeth and I didn't even realize that), tingling of hands/feet/arms, and during a spike you get confusion and you make poor decisions, heart bpm goes to 120 while sitting/laying down.

So, just to mention to not discard that.

In fact a lot of people are experiencing several degrees of anxiety during this period.

None of us experienced this level of stress and anxiety before, the glimpse of uncertainty and the lack of control fucks our mind.

One of the triggers I had was allergy (clogged nose), and other was when I saw news of people acting irresponsibly after me doing my part and giving up a lot of things to try to contain this (I'm not from the US, I'm from the EU).

Boosting this. I’ve had anxiety problems for years and it’s crazy how it can manifest as real physical symptoms. Every doctor visit always ends up with the same diagnosis: anxiety.

Most recently I was 100% convinced I was having a retina detachment. Noticing a ton of “floaters”, sparkles in my vision, etc. Came back from a comprehensive examination at the eye doctor and the diagnosis was yet again, anxiety. After the clean bill of health, a lot of the symptoms disappeared.

You might have had a migraine aura. I have them. One of my coworkers has them too, and they told him it was retina detachment, until he had an episode that lasted one hour before going right back to normal. That was a clue that it was migraine aura all along.
> Boosting this. I’ve had anxiety problems for years and it’s crazy how it can manifest as real physical symptoms. Every doctor visit always ends up with the same diagnosis: anxiety.

I have been taken to the hospital (with blaring sirens) twice for anxiety mimicking heart attack symptoms. Completely checked out and walked out with a healthy heart and alprazolam. It happens only rarely but I carry a strip everywhere just in case as that is not fun.

I tested positive this week. My symptoms are flash headaches and nausea along with persistent ear ringing. No other flu symptoms are present.

I've never had headaches like this before, both in feeling and duration.

I've been careful since the end of February. Always wearing a mask, social distancing, hand washing with soap and disinfectant wipes. I've had limited exposure to other people except delivery people, my GF, my mom. I've only been to stores 3 times since the end of February.

I knew it was just a matter of time when I saw the massive increase in numbers of infected in this county. People almost have completely stopped wearing masks or social distancing.

Luckily, the worst is already over for me. I'm getting better by the day, and it was a short illness too.

I will still use best practices after my self quarantine is over.

So where do you think you caught it? Seems strange that some people take all precautions and still end up getting it.
It seems likely either delivery people, GF, or mom. All it takes is one person in your network to be in someone else's network, and someone there is in someone else's network, and suddenly you get COVID because you thought you were safe and they thought they were safe and they thought they were safe...
> some people take all precautions

The problem is that "some" isn't enough. Everyone needs to work together. sigh

Fine people who do not; they do it here, it is effective.
The known precautions are just to slow the spread down not prevent it, at risk people are still at risk, and so is everyone else. That persons R0 is probably lower than 1, which is the only metric we actually care about.

The only solution is complete segregation and sustainable farming. Otherwise you are fodder as an individual and at best helping the R0 rate decline as well as the velocity of spread.

That isn't strange to me.

Some of the precautions (particularly masks) are primarily around not giving it to others, so you really need _other people_ to be taking the precautions, too.
I'm not a doctor (idk any doctors who browse hackernews) but:

> nausea,headache,confusion,weakness,ataxia

I have experienced these with low oxygen saturation (I have had chronic asthma my whole life, some really bad attacks).

If it's affecting his vision also (black dots) get him checked.. it's known that scar tissue continues to exist on the lungs (similar to pneumonia survival) and will take a very long time (decades) to recover, potentially).

Honestly that sounds like anxiety or stress to me. Your brother should be checked for that. It’s amazing what anxiety/stress can manifest as. Yes, it can cause powerful physical symptoms.
This story is possibly the very last thing I wanted to read today.

Nonetheless, I read it and upvoted it because I like to think of myself as a reality-facing optimist, as opposed to a wishful-thinking optimist. (The landscape of history is littered with the dead bodies of wishful-thinking optimists; I don't want to be one of them.)

After reading this story, along with recent evidence that a substantial portion of covid-19 patients exhibit cardiac anormalities [a] and that herd immunity to covid-19 may be infeasible [b], I realize how little we actually know about this new disease.

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[a] https://academic.oup.com/ehjcimaging/article/doi/10.1093/ehj...

[b] https://www.bbc.com/news/world-europe-53315983

Your conclusion about cardiac abnormalities is wrong, that's not what the study measured.

They only looked at male patients aged 52-74, who were bad enough to be in hospital, and who had already been given an echocardiogram because there was an indicator, i.e. it's the subgroup that doctors deemed in need of a heart check because they were exhibiting symptoms like chest pain. The study indicates prevalence of abnormalities within those echoes - echoes from very ill people with symptoms of heart failure. They didn't take echoes for the study and they didn't run echoes on a random population.

Same can be said of the media's coverage of Covid-19.
Replace Covid-19 with flu than you are right. Fever and T-cells can do a lot of damage. But thankfully they do mostly good things, killing the intruders.
Observed blood clotting and prolonged low oxygen could explain much of this. Then add in the known toxic drugs being used in many cases. It could quite easily be that disease progression and treatment explain this without any direct action from the virus.