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冠状病毒病 (COVID-19):临床特征综合综述。

Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation.

机构信息

Department of Medicine, King Edward Medical University/ Mayo Hospital, Lahore, Pakistan.

Department of Anesthesia and Intensive Care, Post-Graduate Medical Institute/LGH, Lahore, Pakistan.

出版信息

Front Public Health. 2021 Jan 15;8:582932. doi: 10.3389/fpubh.2020.582932. eCollection 2020.

Abstract

COVID-19 is a rapidly growing pandemic with its first case identified during December 2019 in Wuhan, Hubei Province, China. Due to the rampant rise in the number of cases in China and globally, WHO declared COVID-19 as a pandemic on 11th March 2020. The disease is transmitted via respiratory droplets of infected patients during coughing or sneezing and affects primarily the lung parenchyma. The spectrum of clinical manifestations can be seen in COVID-19 patients ranging from asymptomatic infections to severe disease resulting in mortality. Although respiratory involvement is most common in COVID-19 patients, the virus can affect other organ systems as well. The systemic inflammation induced by the disease along with multisystem expression of Angiotensin Converting Enzyme 2 (ACE2), a receptor which allows viral entry into cells, explains the manifestation of extra-pulmonary symptoms affecting the gastrointestinal, cardiovascular, hematological, renal, musculoskeletal, and endocrine system. Here, we have reviewed the extensive literature available on COVID-19 about various clinical presentations based on the organ system involved as well as clinical presentation in specific population including children, pregnant women, and immunocompromised patients. We have also briefly discussed about the Multisystemic Inflammatory Syndrome occurring in children and adults with COVID-19. Understanding the various clinical presentations can help clinicians diagnose COVID-19 in an early stage and ensure appropriate measures to be undertaken in order to prevent further spread of the disease.

摘要

COVID-19 是一种快速发展的大流行疾病,其首例病例于 2019 年 12 月在中国湖北省武汉市发现。由于中国和全球病例数量的迅速增加,世界卫生组织于 2020 年 3 月 11 日宣布 COVID-19 为大流行疾病。该疾病通过感染患者咳嗽或打喷嚏时的呼吸道飞沫传播,主要影响肺实质。COVID-19 患者的临床表现范围从无症状感染到导致死亡的重症疾病。虽然呼吸道受累是 COVID-19 患者最常见的表现,但病毒也会影响其他器官系统。疾病引起的全身炎症以及血管紧张素转换酶 2(ACE2)的多系统表达,ACE2 是一种允许病毒进入细胞的受体,解释了影响胃肠道、心血管、血液、肾脏、肌肉骨骼和内分泌系统的非肺部症状的表现。在这里,我们回顾了 COVID-19 相关的大量文献,内容涉及根据涉及的器官系统以及包括儿童、孕妇和免疫功能低下患者在内的特定人群的临床表现。我们还简要讨论了 COVID-19 患者中发生的多系统炎症综合征。了解各种临床表现可以帮助临床医生在早期诊断 COVID-19,并确保采取适当措施防止疾病进一步传播。

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