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World J Clin Cases. Jan 26, 2023; 11(3): 493-505
Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.493
Non-pulmonary involvement in COVID-19: A systemic disease rather than a pure respiratory infection
Mohamed El-Kassas, Mohamed Alboraie, Mohamed Elbadry, Reem El Sheemy, Mohamed Abdellah, Shimaa Afify, Ahmad Madkour, Mariam Zaghloul, Abeer Awad, Mohamed-Naguib Wifi, Amira Al Balakosy, Mohamed Eltabbakh
Mohamed El-Kassas, Mohamed Elbadry, Ahmad Madkour, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
Mohamed Alboraie, Mohamed Abdellah, Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
Reem El Sheemy, Department of Tropical Medicine, Minia Faculty of Medicine, Minia University, Minia 61511, Egypt
Shimaa Afify, Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 11451, Egypt
Mariam Zaghloul, Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh 33511, Egypt
Abeer Awad, Mohamed-Naguib Wifi, Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo 11451, Egypt
Amira Al Balakosy, Mohamed Eltabbakh, Department of Tropical Medicine, Ain Shams University, Cairo 11451, Egypt
Author contributions: El-Kassas M, Alboraie M, Elbadry M, El Sheemy R, Abdellah M, Afify S, Madkour A, Zaghloul M, Awad A, Wifi MN, Al Balakosy A, and Eltabbakh M equally contributed to writing the manuscript; Alboraie M revised the final manuscript; Awad A submitted the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abeer Awad, MD, Lecturer, Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo University, Kasr Al-Aini Street, Cairo 11451, Egypt. abeer.abdellatif86@gmail.com
Received: July 14, 2022
Peer-review started: July 14, 2022
First decision: October 24, 2022
Revised: November 7, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: January 26, 2023
Processing time: 195 Days and 20.8 Hours
Abstract

During the early phase of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), diagnosis was difficult due to the diversity in symptoms and imaging findings and the variability of disease presentation. Pulmonary manifestations are reportedly the main clinical presentations of COVID-19 patients. Scientists are working hard on a myriad of clinical, epidemiological, and biological aspects to better understand SARS-CoV-2 infection, aiming to mitigate the ongoing disaster. Many reports have documented the involvement of various body systems and organs apart from the respiratory tract including the gastrointestinal, liver, immune system, renal, and neurological systems. Such involvement will result in diverse presentations related to effects on these systems. Other presentations such as coagulation defects and cutaneous manifestation may also occur. Patients with specific comorbidities including obesity, diabetes, and hypertension have increased morbidity and mortality risks with COVID-19.

Keywords: COVID-19; Non-pulmonary; Extrapulmonary; Clinical manifestations; Systemic disease

Core Tip: Pulmonary involvement was taking the upper hand during the early coronavirus disease 2019 pandemic, which was proven to be a rather multisystemic disease. Due to the helpful research efforts that could help in shifting the developing subject area and proper understanding of the nature of the disease for early diagnosis and controlling the spread of the infection.