Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug 13:7:526.
doi: 10.3389/fmed.2020.00526. eCollection 2020.

Pulmonary and Extra-Pulmonary Clinical Manifestations of COVID-19

Kemmian D Johnson  1 , Christen Harris  1 , John K Cain  2 , Cicily Hummer  3 , Hemant Goyal  4 , Abhilash Perisetti  5
Affiliations
Review

Pulmonary and Extra-Pulmonary Clinical Manifestations of COVID-19

Kemmian D Johnson et al. Front Med (Lausanne). .

Abstract

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been recently identified as the culprit of the highly infectious, outbreak named coronavirus disease 2019 (COVID-19) in China. Now declared a public health emergency, this pandemic is present in more than 200 countries with over 14 million cases and 600,000 deaths as of July 18, 2020. Primarily transmitted through the respiratory tract, the most common clinical presentations of symptomatic individuals infected with SARS-CoV-2 include fever, dyspnea, cough, fatigue, and sore throat. In advanced cases, patients may rapidly develop respiratory failure with acute respiratory distress syndrome, and even progress to death. While it is known that COVID-19 manifests similarly to the 2003 Severe Acute Respiratory Syndrome (SARS) and the 2012 Middle East Respiratory Syndrome (MERS), primarily affecting the pulmonary system, the impact of the disease extends far beyond the respiratory system and affects other organs of the body. The literature regarding the extrapulmonary manifestations (cardiovascular, renal, hepatic, gastrointestinal, ocular, dermatologic, and neurological) of COVID-19 is scant. Herein, we provide a comprehensive review of the organ-specific clinical manifestations of COVID-19, to increase awareness about the various organs affected by SARS-CoV-2 and to provide a brief insight into the similarities and differences in the clinical manifestations of COVID-19 and the earlier SARS and MERS.

Keywords: COVID-19; MERS-CoV; SARS-CoV-1; SARS-CoV-2; coronavirus 2019; pneumonia.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Geographic distribution of countries affected by COVID-19 as of April 16, 2020.
Figure 2
Figure 2
Organ-specific clinical manifestations of COVID-19.
Figure 3
Figure 3
Mechanisms of SARS-CoV-2 entry.
Figure 4
Figure 4
Mechanisms of cardiac injury in COVID-19.
Figure 5
Figure 5
Neurological manifestations of COVID-19.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, et al. . A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. (2003) 348:1953–66. 10.1056/NEJMoa030781 - DOI - PubMed
    1. Hui DS, Azhar EI, Kim YJ, Memish ZA, Oh MD, Zumla A. Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission. Lancet Infect Dis. (2018) 18:e217–27. 10.1016/S1473-3099(18)30127-0 - DOI - PMC - PubMed
    1. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. (2020) 25:278–80. 10.1111/tmi.13383 - DOI - PMC - PubMed
    1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. . Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. (2020) 382:1199–207. 10.1056/NEJMoa2001316 - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. (2020) 395:497–506. 10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed