Multiorgan damage and dysfunction due to infection by severe acute respiratory syndrome coronavirus-2 and post-recovery complications

Abstract

Large clusters of patients were reported with pneumonia such as symptoms of unknown causes, all linked to a seafood, and wet animal wholesale market in the city of Wuhan, Hubei Province, China in December 2019. This was followed by studies conducted by the Chinese authorities leading to the detection of a novel strain of coronavirus named as 2019-novel coronavirus. Further studies on the viral genome indicated that the virus is possibly of bat-origin belonging to the genus Betacoronavirus and family Coronaviridae. The name of the virus was changed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to its high similarity with SARS-CoV-1 and the disease was named coronavirus disease-2019 (COVID-19). The disease was declared a pandemic by the WHO by March 12, 2020. As of December 17, 2020, the total cases have been reported to be around 7.29 million with 1.63 million deaths worldwide. Symptoms of the disease can range from severe pneumonia requiring mechanical ventilation to basic symptoms such as fever and cough sometimes even being asymptomatic. Diagnostic tests include different laboratory based, point-of-care, and serological tests for controlling the spread of the disease. It has been indicated that the virus shows its effect by complete immune dysregulation due to excessive release of cytokines which is known as “cytokine storm” leading to the effect on multiple organs mainly the lungs through pneumonia such as symptoms, liver by causing severe damage indicated by high aspartate aminotransferase and alanine aminotransferase levels, kidneys through renal damage, and neurological symptoms being reported in some cases. It also affects circulatory systems through blood coagulation, skin damage, etc. Different symptoms have also been observed post recovery in the respiratory, cardiovascular, endocrine, and immune systems. Currently used treatment strategies are mostly symptomatic that includes use of invasive and non-invasive ventilation and broad spectrum antibiotics and steroids. Furthermore, different novel treatments are also being developed. It is extremely important to conduct further research on the effects of the disease on different organs and post-recovery symptoms to not only develop better diagnostic tools and treatment strategies but also to help people that have already recovered from the disease.