Fluid retention, medically termed edema, is a common bodily response where excess fluid accumulates in body tissues, leading to swelling. This condition can arise from various physiological imbalances, and recent observations indicate a connection between COVID-19 and the manifestation of fluid retention.
What is Fluid Retention
Fluid retention, also known as edema, involves the build-up of fluid within the body’s tissues, resulting in swelling. It commonly affects areas such as the legs, ankles, feet, hands, and face. This occurs when the delicate balance of fluids within the circulatory system is disrupted, causing excess fluid to leak into surrounding tissues.
The body’s fluid balance is maintained by various systems, including the circulatory system, kidneys, and lymphatic system. When fluid leaks from blood vessels into the interstitial spaces between cells, and the lymphatic system cannot adequately drain it, swelling develops. General causes include imbalances in fluid pressure, issues with lymphatic drainage, and conditions affecting kidney or heart function.
How COVID-19 Can Cause Fluid Retention
COVID-19 can lead to fluid retention primarily stemming from the body’s inflammatory response to the virus. The SARS-CoV-2 virus can affect various organ systems, triggering systemic changes that impact fluid balance.
Systemic inflammation, where the body’s immune response to the virus can become overactive, is a significant factor. This heightened inflammatory state can cause the small blood vessels, or capillaries, to become more permeable. When capillaries leak, fluid and proteins shift from the bloodstream into the surrounding tissues, leading to swelling. This is sometimes referred to as capillary leak syndrome, reported in severe COVID-19 cases.
Beyond inflammation, COVID-19 can impact organ function, further contributing to fluid retention. The virus can directly or indirectly affect the kidneys, which are crucial for regulating fluid and electrolyte balance. Acute kidney injury (AKI) is a known complication of COVID-19, and impaired kidney function can lead to the body retaining excess fluid and sodium.
The heart can also be strained by the virus, potentially leading to cardiovascular complications that result in fluid overload. If the heart’s pumping efficiency is compromised, blood can back up, increasing pressure in the veins and causing fluid to accumulate, especially in the legs and lungs. This can manifest as symptoms similar to heart failure.
Certain medications used to treat COVID-19, such as corticosteroids, can also contribute to fluid retention as a side effect. Corticosteroids are known to cause the body to retain water and sodium. Additionally, prolonged immobility or bed rest can hinder circulation and lymphatic drainage, promoting fluid accumulation in the lower extremities.
Symptoms and When to Seek Medical Help
Fluid retention associated with COVID-19 can present with noticeable symptoms. Individuals may observe persistent swelling or puffiness in their limbs, such as the legs, ankles, feet, and hands. The face can also appear swollen, and clothes or jewelry may feel tighter than usual. An unexplained or rapid weight gain over a few days or weeks can also signal fluid accumulation.
The skin over swollen areas might look stretched, shiny, or discolored, and it may feel tight. When pressed, the skin might hold an indent for several seconds, a sign known as pitting edema. Along with visible swelling, individuals might experience aching or heaviness in the affected body parts, and joint stiffness can occur, making movement difficult.
Certain symptoms warrant immediate medical attention. It is important to seek help if the swelling is severe, painful, or begins very suddenly. The presence of redness or warmth in the swollen area, a high temperature, or feeling feverish and shivery should prompt urgent consultation.
Seek emergency care if fluid retention is accompanied by sudden shortness of breath, especially when at rest or lying down, or new chest pain. These symptoms could indicate fluid accumulation in the lungs, a serious condition called pulmonary edema. A healthcare professional conducts a physical examination, reviews medical history, and may order blood tests, urine tests, or imaging to determine the cause and guide management. Management involves addressing the underlying cause, alongside approaches like elevating affected limbs, using compression garments, dietary adjustments, and diuretics.