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Is COVID-19 Infection a Multiorganic Disease? Focus on Extrapulmonary Involvement of SARS-CoV-2

Duloquin et al., Journal of Clinical Medicine, doi:10.3390/jcm13051397

Feb 2024

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Review of the extrapulmonary manifestations of SARS-CoV-2 infection, which can affect multiple organs beyond the lungs including the cardiovascular, neurological, gastrointestinal, renal, hepatic, and dermatologic systems. Authors suggest that endothelial dysfunction and vascular stiffness are the main causal factors for the initiation and progression of SARS-CoV-2 related cardiovascular disease. The virus binds to ACE2 and TMPRSS2 receptors, which are expressed in many tissues, leading to direct viral toxicity, inflammation, and microvascular injury. Neurological complications include anosmia, headache, cognitive impairment, stroke, encephalopathy, Guillain-Barre syndrome, and ICU-acquired weakness. Gastrointestinal symptoms like diarrhea, nausea and vomiting are common and may precede respiratory symptoms. Liver injury, acute kidney injury, new onset diabetes, dermatologic manifestations, and persistent headache and cognitive deficits are also described.

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Duloquin et al., 28 Feb 2024, peer-reviewed, 8 authors. Contact: claudio.rabec@chu-dijon.fr (corresponding author), gauthier.duloquin@chu-dijon.fr, maurice.giroud-ext@chu-dijon.fr, yannick.bejot@chu-dijon.fr, thibaut.pommier@chu-dijon.fr, charles.guenancia@chu-dijon.fr, gabriel.laurent@chu-dijon.fr, marjolaine.georges@chu-dijon.fr.

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Is COVID-19 Infection a Multiorganic Disease? Focus on Extrapulmonary Involvement of SARS-CoV-2

Gauthier Duloquin, Thibaut Pommier, Marjolaine Georges, Maurice Giroud, Charles Guenancia, Yannick Béjot, Gabriel Laurent, Claudio Rabec

Journal of Clinical Medicine, doi:10.3390/jcm13051397

First described in December 2019 in Wuhan (China), COVID-19 disease rapidly spread worldwide, constituting the biggest pandemic in the last 100 years. Even if SARS-CoV-2, the agent responsible for COVID-19, is mainly associated with pulmonary injury, evidence is growing that this virus can affect many organs, including the heart and vascular endothelial cells, and cause haemostasis, CNS, and kidney and gastrointestinal tract abnormalities that can impact in the disease course and prognosis. In fact, COVID-19 may affect almost all the organs. Hence, SARS-CoV-2 is essentially a systemic infection that can present a large number of clinical manifestations, and it is variable in distribution and severity, which means it is potentially life-threatening. The goal of this comprehensive review paper in the series is to give an overview of non-pulmonary involvement in COVID-19, with a special focus on underlying pathophysiological mechanisms and clinical presentation.

Conflicts of Interest: Yannick Béjot received honoraria for lectures or consulting fees from BMS, Pfizer, Medtronic, Amgen, Servier, Novo Nordisk, and Novartis, outside the submitted work. Claudio Rabec received honoraria for lectures or consulting fees from Vitalaire, Resmed, Philips, Asten Santé, Lowenstein Medical, outside the submitted work. Other authors declare no competing interests.

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