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新冠肺炎患者的肺外临床表现。

Extrapulmonary Clinical Manifestations in COVID-19 Patients.

机构信息

Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Am J Trop Med Hyg. 2020 Nov;103(5):1783-1796. doi: 10.4269/ajtmh.20-0986.

Abstract

COVID-19 manifestations in symptomatic patients can be in the form of pneumonia, acute respiratory syndrome, and multiple organ dysfunction as well. Renal complications, gastrointestinal dysfunctions, endocrine system disorders, myocardial dysfunction and arrhythmia, neurological dysfunctions, dermatological symptoms, hematological manifestations, and thromboinflammation are among the reported extrapulmonary complications. Moreover, the presence of coagulopathy, excessive and dysregulated immune responses, and autoimmunity by COVID-19 patients is considerable. The pathogenesis of infection entails the entry of the virus via receptors on cells, principally angiotensin-converting enzyme 2 receptors. Direct virus damage coupled with indirect effects of viral infection including thromboinflammation, dysfunction of the immune system, and dysregulation of the renin-angiotensin system leads to multiple organ failure. This review outlines the extrapulmonary organ-specific complications and their pathophysiology and epidemiology.

摘要

COVID-19 症状患者的临床表现形式可能为肺炎、急性呼吸窘迫综合征和多器官功能障碍等。肾脏并发症、胃肠道功能障碍、内分泌系统紊乱、心肌功能障碍和心律失常、神经系统功能障碍、皮肤症状、血液学表现和血栓炎症等均为已报道的肺外并发症。此外,COVID-19 患者凝血功能障碍、过度和失调的免疫反应以及自身免疫反应较为常见。感染的发病机制包括病毒通过细胞上的受体进入,主要是血管紧张素转换酶 2 受体。直接的病毒损伤加上病毒感染的间接影响,包括血栓炎症、免疫系统功能障碍以及肾素-血管紧张素系统失调,导致多器官衰竭。本综述概述了肺外器官特异性并发症及其病理生理学和流行病学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ac2/7646754/1849504971c7/tpmd200986f1.jpg

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