fever, a dry cough and sometimes shortness of breath.

發燒、乾咳，有時呼吸急促。

But now, researchers have compiled a more exhaustive list, including skin problems,

但是現在，研究人員已經編制了一份更詳盡的清單，包括皮膚問題。

a loss of smell or taste and even neurological symptoms, it can harm the lungs, the kidneys

嗅覺或味覺喪失，甚至出現神經系統症狀，它可以傷害肺部、腎臟

and even the circulatory system.

甚至是循環系統。

And what about those purple COVID toes?

而那些紫色的COVID腳趾呢？

When COVID-19 began I think it was surreal for all of us, and as a physician, me and

當COVID-19開始時，我認為這對我們所有人來說都是不真實的，作為一名醫生，我和

my colleagues around me in really every specialty recognized this was a special time in our

我周圍每個專業的同事都認識到這是我們的一個特殊時期。

careers where we had an opportunity to potentially make more of a difference in the world than

在這裡，我們有機會為世界帶來更多的改變。

we may ever have in our entire lives.

我們可能在我們的整個生命中都有過。

Dr. Fernandez is

費爾南德斯博士是

one of the many doctors and researchers focusing on the symptoms or manifestations of COVID-19,

眾多專注於COVID-19症狀或表現的醫生和研究人員之一。

to better understand what exactly we're dealing with.

以更好地瞭解我們到底在處理什麼問題。

My name is Dr. Anthony Fernandez, I am a dermatologist and a dermatopathologist at the Cleveland

我的名字是安東尼-費爾南德斯博士，我是克利夫蘭大學的皮膚科醫生和皮膚病理學家。

Clinic in Cleveland, Ohio. Every virus is unique in three dimensional structure, and

位於俄亥俄州克利夫蘭的診所。每個病毒的三維結構都是獨一無二的，而且

because of that activates the immune system in different ways, and that creates different

因為這以不同的方式激活了免疫系統，而這產生了不同的

manifestations.

表現形式。

Collecting information about the array of symptoms associated with COVID is a good way

收集與COVID相關的一系列症狀的資訊是一個很好的方法。

for experts to understand what exactly the virus is doing in the human body and how it's

專家們要了解該病毒在人體中的確切作用以及它是如何在人體中發揮作用的。

moving around,

四處走動。

when a patient is first infected with SARS-CoV-2, the virus that causes COVID-19, it's

當病人首次感染SARS-CoV-2（引起COVID-19的病毒）時，它是

usually inhaled, and it begins to infect cells in the respiratory tract and produces more

通常是吸入，它開始感染呼吸道的細胞，併產生更多的病毒。

and more virus.

和更多的病毒。

This is why we wear masks... Duh!

這就是為什麼我們要戴口罩...咄！

From here, the virus can work its way into tiny air sacs in the lungs.

從這裡，病毒可以進入肺部的微小氣囊。

These air sacs are filled with a protein receptor called ACE2 and this is what the virus

這些氣囊中充滿了一種叫做ACE2的蛋白質受體，這就是病毒的作用。

uses to break into cells where it can replicate and spread.

用來闖入它可以複製和傳播的細胞。

Another group of cells that produces ACE2 is the cells that line blood vessels throughout

另一組產生ACE2的細胞是遍佈血管的細胞。

the body, and because of this the virus can invade those too.

由於這個原因，病毒也可以入侵這些地方。

This can cause the blood vessels to leak and the blood to clot.

這可能導致血管洩漏和血液凝結。

That virus, as do most viral infections, eventually involve that virus getting into the bloodstream

這種病毒和大多數病毒感染一樣，最終涉及到該病毒進入血液中

and circulating throughout the body.

並在整個身體內循環。

Blood clots can lead to heart attacks, strokes and tissue damage.

血凝塊可導致心臟病發作、中風和組織損傷。

So, this is where those cardiovascular and neurological symptoms can come into play.

是以，這就是那些心血管和神經系統症狀可以發揮作用的地方。

The virus can also interfere with your nervous system but this needs more research, there

該病毒還可能干擾你的神經系統，但這需要更多的研究，有

are some clues that the virus infects nasal cells, potentially causing a block in how

有一些線索表明，病毒感染了鼻腔細胞，可能會導致鼻腔細胞的功能受阻。

these cells communicate with the brain, hence the loss of smell and taste that some

這些細胞與大腦溝通，是以有些人失去了嗅覺和味覺。

patients experience.

患者的經驗。

And of course there's a reason we wanted to talk to a dermatologist

當然，我們想和皮膚科醫生談談也是有原因的

slash dermatopathologist. In the skin, it still seems to be a little bit unclear, but

斜線的皮膚病理學家。在皮膚方面，似乎仍有一點不清楚，但

it may infect the blood vessel cells that traffic through the skin, or it may be that

它可能感染了通過皮膚運輸的血管細胞，或者可能是

the immune system cells in the blood are simply activated by the presence of that virus and

血液中的免疫系統細胞只是因為該病毒的存在而被激活，並且

emits signals that then activate the immune system cells that are in the skin.

發出信號，然後激活皮膚中的免疫系統細胞。

You may have heard of

你可能聽說過

those infamous COVID toes, red or purple, itchy bumps on the toes and sometimes the

那些臭名昭著的COVID腳趾，腳趾上有紅色或紫色的瘙癢疙瘩，有時還有

fingers.

手指。

One of the arguments for why patients may get these COVID toe lesions, if it is specific

為什麼病人可能得到這些COVID腳趾病變的論據之一，如果它是特定的

to COVID-19, is that these young patients have very well functioning immune systems

對COVID-19來說，這些年輕患者的免疫系統功能非常好

and mount a very robust response against that virus as soon as it enters the body, and eliminate

並在該病毒進入人體後立即對其作出非常有力的反應，並將其消滅。

it effectively and rapidly before it can reproduce to high numbers in the body.

在它能夠在體內繁殖到高數量之前，有效而迅速地將其消滅。

So the rash might be an indicator of really high immune system activity.

所以皮疹可能是免疫系統真正高度活躍的一個指標。

But then again these toe troubles might have nothing to do with the virus at all.

但話說回來，這些腳趾的麻煩可能與病毒一點關係都沒有。

And so another theory is that it's really lifestyle changes during quarantine. Individuals

是以另一個理論是，這確實是隔離期間生活方式的改變。個人

walking around bare feet around their house or spending their days doing different activities

光著腳在家裡走來走去，或者每天都在做不同的活動

than they otherwise normally would, is really what is precipitating more cases of the so

比正常情況下更多，這才是真正促使更多如此的案件發生的原因。

called COVID toes.

稱為COVID的腳趾。

So while COVID toes are still a bit of a mystery, the skin matters when it comes to understanding

是以，儘管COVID的腳趾仍然有點神祕，但在理解時，皮膚很重要

COVID-19 because it's such a vital part of the immune system.

COVID-19是因為它是免疫系統的一個重要部分。

If you think about your body as a castle, then you can think about your skin as that

如果你把你的身體看成是一座城堡，那麼你可以把你的皮膚看成是城堡。

big wall around the castle.

城堡周圍的大牆。

That is put there to serve as a main barrier to keep all the bad things in the outside

這是把它作為一個主要的屏障，把所有的壞東西放在外面。

world out, and your body recognizes the importance of the skin and in defending that wall, and

你的身體認識到了皮膚的重要性，並且在捍衛這堵牆的過程中，你的身體也認識到了皮膚的重要性。

so it invests a lot of energy in lining that wall with troops, which represent immune system

是以，它投入了大量的能量，用代表免疫系統的部隊來襯托這堵牆。

cells.

細胞。

Many things can cause those cells to become activated invading things from the outside

許多事情可以導致這些細胞被激活，從外部入侵的東西。

world can immediately cause those cells to become activated as they try to defend that

世界會立即導致這些細胞被激活，因為它們試圖保衛這個世界。

wall that barrier from anything getting inside of it, but also those immune system cells

壁壘，防止任何東西進入它的內部，但也有那些免疫系統細胞

can hear signals from

可以聽到來自

within the body. The skin can be a hint at how a disease will progress. With COVID, there's

在身體內。皮膚可以提示疾病將如何發展。有了COVID，就有了

a particular rash that dermatologists are studying to see if it might indicate the internal

皮膚科醫生正在研究一種特殊的皮疹，以確定它是否可能表明內部的疾病。

blood clotting that we talked about earlier.

我們之前談到的血液凝固問題。

The other manifestation that we have seen, especially in severely ill patients with COVID-19.

我們看到的另一種表現，特別是在患有COVID-19的重症患者中。

Typically patients who are intubated who need a mechanical ventilator to breathe for them

通常是插管的病人，他們需要機械呼吸機為他們呼吸。

because of the degree of inflammation in their lungs, is what we call retiform purpura or

因為他們肺部的發炎程度，就是我們所說的雷蒂型紫癜或

a violaceous rash, but what we recognize as being a clue that there is some vascular insult

一個暴力性的皮疹，但我們認為這是一個線索，即有一些血管損傷。

going on underneath the skin, either clotting in the blood vessels or inflammation around

在皮膚下發生的事情，要麼是血管中的凝結，要麼是周圍的發炎。

the blood vessels, which we call vasculitis.

血管，我們稱之為脈管炎。

And as for side effects of the vaccine...

而至於疫苗的副作用...

One of the most common manifestations in the skin has now been dubbed COVID arm and essentially represents

皮膚上最常見的表現之一現在被稱為COVID手臂，基本上代表了

a large oval to round, pink to red rash raised area called a plaque on the arm, the lateral arm at the injection site.

胳膊上有一個大的橢圓形至圓形、粉紅色至紅色的皮疹隆起區，稱為斑塊，在注射部位的側臂。

It's usually asymptomatic, and it really has no consequences so it does not need to

它通常是無症狀的，而且確實沒有後果，所以它不需要

be treated.

被治療。

It is not an indication that the vaccine will not be effective or is going to cause some

這並不表明疫苗不會有效或將會引起一些

other problem in the patient.

病人的其他問題。

It probably simply represents activation of the immune system, and that area of the

它可能只是代表了免疫系統的激活，而該區域的

body.

身體。