COVID-19 can affect almost all organs and not just the lungs and the initial symptoms may be totally unrelated to chest complaints, said experts at AIIMS on Wednesday.

The AIIMS' experts stressed that classification of cases into mild, moderate and severe categories based just on respiratory symptoms should be relooked to include other organ involvement.

The AIIMS' experts were discussing the various possible extra-pulmonary complications of COVID-19 during their weekly ‘National Clinical Grand Rounds’ organised in collaboration with NITI Aayog.

The team of experts who took part in the discussion were AIIMS director Dr Randeep Guleria; head of the department of Neurology Dr MV Padma Srivastava; Professor of Cardiology Dr Ambuj Roy and Associate Professor in the Department of Medicine Dr Neeraj Nischal.

"Eight months into COVID-19 and we have been able to learn a lot and accordingly strategies are being changed from time to time," said AIIMS Director Dr Guleria.

"From what we thought of as viral pneumonia has a lot of other manifestations which are beyond the lungs," he said.

"As we have known more and more about COVID-19, we have realised it causes many extrapulmonary manifestations," he said.

"This is basically of the fact that this virus enters into the cell through ACE2 receptors which although are present abundantly in upper airways and lungs, they are also present in many organs and thus other organs are also affected," he added.

"We have seen many patients who presented with features which are not been predominantly pulmonary but extrapulmonary manifestations," Dr Guleria added.

"Pulmonary manifestations continue to dominate as far as the majority of COVID-19 cases are concerned," he said.

"However, there is a significant number of patients who would present with manifestations which may be along with pulmonary manifestations or maybe without pulmonary manifestations," he added.

The experts presented a number of cases in which the patients were labelled as asymptomatic or mild COVID but had serious life-threatening extra-pulmonary manifestations like stroke and heart blocks.