Extrapulmonary manifestations and complications of severe acute respiratory syndrome coronavirus-2 infection: a systematic review.

Autor:	Cho J; Division of Rheumatology, Department of Medicine, National University Hospital; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Lee J; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Haematology, National University Cancer Institute, National University Hospital, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore., Koo CS; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Gastroenterology, Department of Medicine, National University Hospital, Singapore., Tan BYQ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore., Hong W; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Nephrology, Department of Medicine, National University Hospital, Singapore., Choi E; Division of Dermatology, Department of Medicine, National University Hospital, Singapore., Goh X; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Otolaryngology - Head and Neck Surgery (ENT), National University Hospital, Singapore., Chai L; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore., Chandran NS; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Dermatology, Department of Medicine, National University Hospital, Singapore., Chua HR; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Nephrology, Department of Medicine, National University Hospital, Singapore., L Chan BP; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore., Muthiah M; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Gastroenterology, Department of Medicine, National University Hospital, Singapore., Low TT; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore., Yap ES; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Division of Haematology, National University Cancer Institute, National University Hospital, Singapore., Lahiri M; Division of Rheumatology, Department of Medicine, National University Hospital; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	Singapore medical journal [Singapore Med J] 2023 Jun; Vol. 64 (6), pp. 349-365.
DOI:	10.11622/smedj.2021100
Abstrakt:	Introduction: We aimed to describe the extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including their frequency, onset with respect to respiratory symptoms, pathogenesis and association with disease severity. Methods: We searched the MEDLINE and Embase databases for SARS-CoV-2-related studies. Meta-analysis, observational studies, case series and case reports published in English or Chinese between 1 January 2020 and 1 May 2020 were included. Reports with only paediatric or obstetric cases were excluded. Results: 169 articles were included. Early manifestations (preceding respiratory symptoms until Day 6 of onset) included olfactory and gustatory disturbance (self-reported in up to 68% and 85% of cases, respectively), gastrointestinal symptoms (up to 65.9%) and rash (up to 20.4%). From Day 7 onwards, hypercytokinaemia, paralleled multi-organ complications including acute cardiac injury (pooled incidence of 17.7% in 1,412 patients, mostly with severe disease and 17.4% mortality), kidney and liver injury (up to 17% and 33%, respectively) and thrombocytopenia (up to 30%). Hypercoagulability resulted in venous thromboembolic events in up to 31% of all patients. Uncommon disease presentation and complications comprised Guillain-Barré syndrome, rhabdomyolysis, otitis media, meningoencephalitis and spontaneous pneumomediastinum. Conclusion: Although the systemic manifestations of SARS-CoV-2 infection are variegated, they are deeply interwoven by shared mechanisms. Two phases of extrapulmonary disease were identified: (a) an early phase with possible gastrointestinal, ocular and cutaneous involvement; and (b) a late phase characterised by multiorgan dysfunction and clinical deterioration. A clear, multidisciplinary consensus to define and approach thromboinflammation and cytokine release syndrome in SARS-CoV-2 is needed. Competing Interests: None
Databáze:	MEDLINE
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