CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
J Mol Histol. 2020 Dec;51(6):613-628. doi: 10.1007/s10735-020-09915-3. Epub 2020 Oct 4.
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in December 2019 form Wuhan, China leads to coronavirus disease 2019 (COVID-19) pandemic. While the common cold symptoms are observed in mild cases, COVID-19 is accompanied by multiorgan failure in severe patients. The involvement of different organs in severe patients results in lengthening the hospitalization duration and increasing the mortality rate. In this review, we aimed to investigate the involvement of different organs in COVID-19 patients, particularly in severe cases. Also, we tried to define the potential underlying mechanisms of SARS-CoV2 induced multiorgan failure. The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. The most important mechanisms are related to the direct and indirect pathogenic features of SARS-CoV2. Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs. Moreover, the organ failure may be induced by the cytokine storm, a result of increased levels of inflammatory mediators, endothelial dysfunction, coagulation abnormalities, and infiltration of inflammatory cells into the organs. Therefore, further investigations are needed to detect the exact mechanisms of pathogenesis. Since the involvement of several organs in COVID-19 patients is important for clinicians, increasing their knowledge may help to improve the outcomes and decrease the rate of mortality and morbidity.
2019 年 12 月，严重急性呼吸综合征冠状病毒 2（SARS-CoV2）在中国武汉爆发，导致 2019 年冠状病毒病（COVID-19）大流行。虽然轻症患者表现出普通感冒症状，但 COVID-19 会导致重症患者多器官衰竭。重症患者不同器官受累导致住院时间延长，死亡率增加。在这篇综述中，我们旨在研究 COVID-19 患者，尤其是重症患者的不同器官受累情况。同时，我们试图确定 SARS-CoV2 引起多器官衰竭的潜在潜在机制。多器官功能障碍的特征是急性呼吸衰竭、急性肝功能衰竭、急性肾损伤、心血管疾病以及广泛的血液异常和神经系统疾病。最重要的机制与 SARS-CoV2 的直接和间接致病特征有关。虽然已经证实 SARS-CoV2 的肺、心脏、肾脏、睾丸、肝脏、淋巴细胞和神经系统中存在血管紧张素转换酶 2（SARS-CoV2 的受体），但关于这些器官中是否存在 SARS-CoV2 RNA 的观察结果存在争议。此外，器官衰竭可能是由细胞因子风暴引起的，这是炎症介质水平升高、内皮功能障碍、凝血异常和炎症细胞浸润到器官的结果。因此，需要进一步研究以检测发病机制的确切机制。由于 COVID-19 患者涉及多个器官，这对临床医生很重要，增加他们的知识可能有助于改善结果并降低死亡率和发病率。
