Extrapulmonary manifestations of COVID-19.

Autor: Gupta A; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA., Madhavan MV; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Sehgal K; Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Nair N; Division of Endocrinology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, NY, USA., Mahajan S; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.; Division of Cardiology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA., Sehrawat TS; Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA., Bikdeli B; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA., Ahluwalia N; Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Ausiello JC; Division of Endocrinology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, NY, USA., Wan EY; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Freedberg DE; Division of Digestive and Liver Diseases, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Kirtane AJ; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Parikh SA; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Maurer MS; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Nordvig AS; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the NewYork-Presbyterian Hospital, New York, NY, USA., Accili D; Division of Endocrinology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, NY, USA., Bathon JM; Division of Rheumatology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Mohan S; Division of Nephrology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA., Bauer KA; Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Leon MB; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Krumholz HM; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.; Division of Cardiology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA., Uriel N; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Mehra MR; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA, USA., Elkind MSV; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the NewYork-Presbyterian Hospital, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA., Stone GW; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; Division of Cardiology, Department of Medicine, the Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Schwartz A; Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Ho DD; Aaron Diamond AIDS Research Center, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA., Bilezikian JP; Division of Endocrinology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, NY, USA., Landry DW; Division of Nephrology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA. dwl1@cumc.columbia.edu.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2020 Jul; Vol. 26 (7), pp. 1017-1032. Date of Electronic Publication: 2020 Jul 10.
DOI: 10.1038/s41591-020-0968-3
Abstrakt: Although COVID-19 is most well known for causing substantial respiratory pathology, it can also result in several extrapulmonary manifestations. These conditions include thrombotic complications, myocardial dysfunction and arrhythmia, acute coronary syndromes, acute kidney injury, gastrointestinal symptoms, hepatocellular injury, hyperglycemia and ketosis, neurologic illnesses, ocular symptoms, and dermatologic complications. Given that ACE2, the entry receptor for the causative coronavirus SARS-CoV-2, is expressed in multiple extrapulmonary tissues, direct viral tissue damage is a plausible mechanism of injury. In addition, endothelial damage and thromboinflammation, dysregulation of immune responses, and maladaptation of ACE2-related pathways might all contribute to these extrapulmonary manifestations of COVID-19. Here we review the extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
Databáze: MEDLINE
Externí odkaz: