New understanding of the damage of SARS-CoV-2 infection outside the respiratory system

Abstract

Since early December 2019, a number of pneumonia cases associated with unknown coronavirus infection were identified in Wuhan, China, and many additional cases were identified in other regions of China and in other countries within 3 months. Currently, more than 80,000 cases have been diagnosed in China, including more than 3000 deaths. The epidemic is spreading to the rest of the world, posing a grave challenge to prevention and control. On February 12, 2020, the International Committee on Taxonomy of Viruses and the World Health Organization officially named the novel coronavirus and associated pneumonia as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19), respectively. According to the recent research on SARS-CoV-2, the virus mainly infects the respiratory system but may cause damage to other systems. In this paper, we will systematically review the pathogenic features, transmission routes, and infection mechanisms of SARS-CoV-2, as well as any adverse effects on the digestive system, urogenital system, central nervous system, and circulatory system, in order to provide a theoretical and clinical basis for the diagnosis, classification, treatment, and prognosis assessment of SARS-CoV-2 infection.

Keywords: COVID-19; Central nervous system; Circulatory system; Digestive system; SARS-CoV-2; Urogenital system.

Graphical abstract

Fig. 1

SARS-CoV-2 invades cellular mechanisms. ①SARS-CoV-2 entry. ②Membrane fusion and viral RNA release. ③Translation. ④Some of these proteins from 3 and RNA from 2 form a replication complex to make more RNA. ⑤SARS-CoV-2 packaging in golgi. ⑥SARS-CoV-2 release.

Fig. 2

Inflammatory storm mechanism. ①Antigen presenting. ②T cells activate and start reproducing. ③A large amount of cytokine are secreted during T cell activation. B cells, macrophage and NK cells will be activated by these cytokine. ④Activated T cells release cytokine and activate more B cells, macrophage and NK cells. ⑤Cytokine secreted.