Which Organ System Is Most Often Affected by COVID-19?

Medically Reviewed on 12/22/2021
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Lungs are the main organs affected by COVID-19; however, the virus can also affect other organs, such as the kidneys, brain, and liver.

Lungs are the main organs affected by COVID-19. Besides the lungs, the SARS-CoV-2 virus affects other parts of the respiratory system, such as the trachea (windpipe), nasal cavity, and throat.

Although COVID-19 mainly affects the lungs (pulmonary disease), studies done so far suggest that it can affect almost every organ in the body (extrapulmonary disease). Nonetheless, it is not certain which organs or organ systems will be involved in this disease in a particular person. Even the severity of organ involvement by COVID-19 varies with people.

Apart from the lungs, other organs or tissues affected by COVID-19 include:

  • Cardiovascular system (consisting of the heart and blood vessels)
  • Kidneys
  • Brain
  • Gastrointestinal system or the gut
  • Skin
  • Blood
  • Pancreas
  • Liver
  • Eyes
  • Joints
  • Muscles
  • Immune system

A type of severe and often life-threatening complication of COVID-19 is called multisystem inflammatory syndrome in children (MIS-C) or pediatric multisystem inflammatory syndrome (PMIS).

  • This condition is mainly seen in children and teens and results due to an overreaction of the immune system against the coronavirus.
  • It may cause symptoms, such as fever, skin rash, bloodshot eyes, swelling over the hands, feet, and tongue, abdominal pain, and swollen neck glands.
  • It can turn fatal if not timely treated.

How does COVID-19 affect the lungs?

The lungs are the first site affected by COVID-19.

  • The cells that line the airways have certain proteins on their surface called the ACE-2 receptors.
  • The SARS-CoV-2 virus attaches to these receptors and enters the cells in the lungs. 
  • Once entered, the virus rapidly multiplies to form more viral particles that invade more cells in the airways.
  • The spread of the infection in the lungs leads to an immune response by the body.
  • In severe cases, this fight between the virus and the immune system may lead to the formation of a lot of debris and fluid collection in the lungs.

The lung involvement may cause symptoms, such as cough and shortness of breath, which may vary in severity depending on the extent of the disease.

COVID-19 can result in several pulmonary (related to the lungs) complications, such as pneumonia, acute respiratory distress syndrome (ARDS), and respiratory failure.

Acute respiratory distress syndrome or ARDS is a severe lung complication of COVID-19.

  • In ARDS, the tiny air sacs (alveoli) in the lungs get filled with fluid leaking from the lung capillaries (the tiny blood vessels in the lungs).
  • The alveoli are the site where the exchange of gases (oxygen and carbon dioxide) occurs between the blood and the lungs.
  • ARDS hampers this exchange, resulting in a decline in oxygen levels and the buildup of carbon dioxide in the lungs.
  • The affected person experiences severe breathing difficulty and may need ventilator support to survive.

People with underlying health conditions, including chronic lung diseases (such as chronic obstructive pulmonary disease, asthma, and pulmonary hypertension) are at a greater risk of severe pulmonary complications of COVID-19.

Does COVID-19 affect your mental health?

COVID-19 has been found to affect mental health (psychiatric manifestations), causing issues such as:

The psychiatric symptoms may be caused by the effect of COVID-19 on the brain. It is often termed “brain fog” by the people, wherein they report forgetfulness and disorientation for weeks after COVID-19.

The mental health issues may be caused by other factors, such as fear of the disease, confinement, loneliness, and financial issues associated with the disease.

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Medically Reviewed on 12/22/2021
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Ramos-Casals M, Brito-Zerón P, Mariette X. Systemic and organ-specific immune-related manifestations of COVID-19. Nat Rev Rheumatol. 2021 Jun;17(6):315-332. https://www.nature.com/articles/s41584-021-00608-z

Son MBF, Friedman K. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) management and outcome. UpToDate. https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-management-and-outcome?search=MISC&source=search_result&selectedTitle=1~55&usage_type=default&display_rank=1

Stein MB. COVID-19: Psychiatric illness. UpToDate. https://www.uptodate.com/contents/covid-19-psychiatric-illness?search=psychiatric%20covid&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1