2019年12月在武汉爆发严重急性呼吸道综合症冠状病毒2(SARS-CoV2),中国导致2019年冠状病毒病(COVID-19)大流行。虽然在轻度病例中观察到普通感冒症状,COVID-19在重症患者中伴有多器官功能衰竭。重症患者不同器官的受累导致住院时间延长并增加死亡率。在这次审查中,我们旨在调查COVID-19患者不同器官的受累情况,特别是在严重的情况下。此外,我们试图确定SARS-CoV2诱导多器官衰竭的潜在潜在机制.多器官功能障碍的特点是急性肺衰竭,急性肝功能衰竭,急性肾损伤,心血管疾病,以及广泛的血液学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。尽管在肺中存在血管紧张素转换酶2,SARS-CoV2的受体,心,肾,睾丸,肝脏,淋巴细胞,神经系统得到证实,关于在这些器官中观察到SARS-CoV2RNA,有争议的发现。此外,器官衰竭可能是由细胞因子风暴引起的,炎症介质水平升高的结果,内皮功能障碍,凝血异常,炎症细胞渗入器官。因此,需要进一步的研究来检测发病的确切机制。由于COVID-19患者的多个器官受累对临床医生很重要,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。
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.