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COVID-19 and multiorgan failure: A narrative review on potential mechanisms.
J Mol Histol. 2020 Dec; 51(6):613-628.JM

Abstract

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.

Authors+Show Affiliations

CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. hassanzadeh@tums.ac.ir. Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. hassanzadeh@tums.ac.ir. Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. hassanzadeh@tums.ac.ir.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33011887

Citation

Mokhtari, Tahmineh, et al. "COVID-19 and Multiorgan Failure: a Narrative Review On Potential Mechanisms." Journal of Molecular Histology, vol. 51, no. 6, 2020, pp. 613-628.
Mokhtari T, Hassani F, Ghaffari N, et al. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol. 2020;51(6):613-628.
Mokhtari, T., Hassani, F., Ghaffari, N., Ebrahimi, B., Yarahmadi, A., & Hassanzadeh, G. (2020). COVID-19 and multiorgan failure: A narrative review on potential mechanisms. Journal of Molecular Histology, 51(6), 613-628. https://doi.org/10.1007/s10735-020-09915-3
Mokhtari T, et al. COVID-19 and Multiorgan Failure: a Narrative Review On Potential Mechanisms. J Mol Histol. 2020;51(6):613-628. PubMed PMID: 33011887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 and multiorgan failure: A narrative review on potential mechanisms. AU - Mokhtari,Tahmineh, AU - Hassani,Fatemeh, AU - Ghaffari,Neda, AU - Ebrahimi,Babak, AU - Yarahmadi,Atousa, AU - Hassanzadeh,Ghomareza, Y1 - 2020/10/04/ PY - 2020/07/30/received PY - 2020/09/26/accepted PY - 2020/10/5/pubmed PY - 2020/11/3/medline PY - 2020/10/4/entrez KW - Angiotensin-converting enzyme-2 KW - COVID-19 KW - Coagulation KW - Cytokine storm KW - Multi-organ failure KW - SARS-CoV2 SP - 613 EP - 628 JF - Journal of molecular histology JO - J Mol Histol VL - 51 IS - 6 N2 - 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. SN - 1567-2387 UR - https://www.unboundmedicine.com/medline/citation/33011887/COVID_19_and_multiorgan_failure:_A_narrative_review_on_potential_mechanisms_ L2 - https://doi.org/10.1007/s10735-020-09915-3 DB - PRIME DP - Unbound Medicine ER -