Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, and COVID-19, beyond the l
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CHEST RADIOLOGY
Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, and COVID‑19, beyond the lungs: a review article Alecio F. Lombardi1 · Amir M. Afsahi1 · Amit Gupta2 · Ali Gholamrezanezhad3 Received: 17 August 2020 / Accepted: 15 November 2020 © Italian Society of Medical Radiology 2020
Abstract Background In the past 20 years four major viral infectious diseases outbreaks caused hundreds of thousands of deaths worldwide: SARS, Influenza H1N1, MERS, and COVID-19. They all present clinically initially as upper and lower respiratory tract infections and may progress to multi-organ failure. Methods This study was a systematic review of literature conducted in September 2020 to study extra-pulmonary complications of SARS, FLU, MERS, and current COVID-19. We carried out a systematic search using the keywords in online databases of PubMed, EMBASE, and Google Scholar until June 2020. Objective This article aims to review the most common extra-pulmonary manifestations of SARS, Influenza, MERS, and COVID-19. Discussion Several studies have reported extra-pulmonary conditions in patients diagnosed with SARS, Influenza, MERS, and COVID-19, either by direct viral injury or from the systemic response to the initial infection. Conclusion SARS, Influenza, MERS, and COVID-19 have all been associated with dysfunction of kidneys, endocrine system, neuromuscular symptoms, perinatal complications, and myocardial injury. Progression from pulmonary disease to a systemic condition has a poor outcome and can result in multi-organ failure. Keywords COVID-19 · SARS · MERS · FLU · Extra-pulmonary · Complications · Pneumonia
Introduction Recently severe acute viral infections have caused significant death toll globally through four major pandemics in the past 20 years. The severe acute respiratory syndrome (SARS) first appeared in 2002 and caused 774 deaths worldwide. In 2009 a new H1N1 influenza A virus caused another Alecio F. Lombardi and Amir M. Afsahi equally contributed to the current study. * Ali Gholamrezanezhad [email protected] 1
Department of Radiology, University of California, San Diego, CA, USA
2
Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
3
Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1500 San Pablo Street, Health Sciences Campus, Los Angeles, CA, USA
pandemic, affecting 60.8 million people and causing 12,469 deaths only in the USA. In 2012, a new coronavirus (MERSCoV) was recognized to cause the Middle East respiratory syndrome (MERS) that presented with more than 30% mortality (858 reported deaths) and spread to 27 countries. In December 2019, a new coronavirus (SARS-CoV-2) surged in China, causing the current COVID-19 pandemic. The high viral infectivity caused the disease to spread throughout the world rapidly. More than 7.76 million cases in more than 188 countries, resulting in more than 429,000 deaths, have been reported to the present day. This article aims
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