Sabah Mohamed Alharazy*

Independent Researcher, Malaysia

*Corresponding Author: Sabah Mohamed Alharazy, Independent Researcher, Malaysia.

Received: June 15, 2021; Published: July 13, 2021

Abstract

  The world is still facing the coronavirus disease 2019 (COVID-19) pandemic caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), since it first appeared in Wuhan, China, in December 2019. The virus primarily affects the respiratory system, but increasing evidence indicates that SARS-CoV-2 can affect multiple organ systems and causes several complications. The risk factors for disease severity and complications of COVID-19 include cancer, cerebrovascular disease, chronic kidney disease, chronic obstructive pulmonary disease (COPD), and other lung diseases, diabetes mellitus, down syndrome, heart conditions, human immunodeficiency virus (HIV) infection, neurologic conditions, obesity, pregnancy, smoking, sickle cell disease, solid organ or blood stem cell transplantation, substance use disorders, use of corticosteroids or other immunosuppressive medications. Since older people have one or more coexisting medical conditions, they are probably at the highest risk for fatal COVID-19 infections. COVID-19 disease severity can range from mild to critical, with the majority having only mild disease. The most common complication of this disease is acute respiratory distress syndrome (ARDS). Other complications include cardiovascular, renal, neurologic, thrombotic complications, liver injury, as well as bacterial, viral, and fungal coinfections. This review summarizes the current understanding of the risk factors, the severity of COVID-19 infection, and the most common complications of this disease.

Keywords: Coronavirus Disease 2019 (COVID-19); Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); Risk Factors; Severity; Complications; Severe Acute Respiratory Distress Syndrome

References

1. Word Health Organization.“Novel Coronavirus (2019-nCoV): Situation Report 21 January 2020”. WHO (2020): 1.
2. Word Health Organization. “Naming the coronavirus disease (COVID-19) and the virus that causes it”. WHO (2020).
3. Gupta A., et al. “Extrapulmonary manifestations of COVID-19”. Nature Medicine7 (2020): 1017-1032.
4. Wu C., et al. “Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China”. JAMA Internal Medicine7 (2020): 934-43.
5. Chen N., et al. “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study”. The Lancet10223 (2020): 507-513.
6. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. The Lancet10223 (2020): 497-506.
7. Babapoor-Farrokhran S., et al. “Myocardial injury and COVID-19: Possible mechanisms”. Life sciences 253 (2020): 117723.
8. Yang J., et al. “Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis”. International Journal of Infectious Diseases 94 (2020): 91-95.
9. Wang D., et al. “Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China”. JAMA - Journal of the American Medical Association11 (2020): 1061-1069.
10. Yang X., et al. “Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study”. The Lancet Respiratory Medicine5 (2020): 475-481.
11. Mao L., et al. “Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China”. JAMA Neurology 6 (2020): 683-690.
12. Wu Y., et al. “Nervous system involvement after infection with COVID-19 and other coronaviruses”. Brain, Behavior, and Immunity 87 (2020): 18-22.
13. Klok FA., et al. “Incidence of thrombotic complications in critically ill ICU patients with COVID-19”. Thrombosis Research 191 (2020): 145-147.
14. Ghoda A., et al. “Liver Injury in COVID-19 Infection: A Systematic Review”. Cureus7 (2020): e9487.
15. Phipps MM., et al. “Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large U.S. Cohort”. Hepatology 3 (2020): 807-817.
16. Cates J., et al. “Risk for In-Hospital Complications Associated with COVID-19 and Influenza — Veterans Health Administration, United States, October 1, 2018-May 31, 2020”. MMWR Morbidity and Mortality Weekly Report42 (2020): 1528-1534.
17. Lansbury L., et al. “Co-infections in people with COVID-19: a systematic review and meta-analysis”. The Journal of Infection2 (2020): 266-275.
18. World Health Organization. “Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)”. WHO (2020): 16-24.
19. National Center for Immunization and Respiratory Diseases (NCIRD). “Certain Medical Conditions and Risk for Severe COVID-19 Illness”. Centers for Diseases Control (2020).
20. “Comorbidities CDC classifies as risk factors for severe COVID-19”. UpToDate (2021).
21. Wong CKH., et al. “Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis”. Scientific Reports1 (2020): 19765.
22. Epidemiology Working Group for NCIP Epidemic Response CC for DC and P. “[The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]”. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2 (2020): 145-151.
23. Epidemiology for public health. Istituto Superiore di Sanità. “Characteristics of SARS-CoV-2 patients dying in Italy”. Istituto Superiore di Sanità (2020).
24. Chow N., et al. “Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12-March 28, 2020”. MMWR Morbidity and Mortality Weekly Report13 (2020): 382-386.
25. Rodriguez-Morales AJ., et al. “Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis”. Travel Medicine and Infectious Disease 34 (2020).
26. Suleyman G., et al. “Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit”. JAMA Netw Open6 (2020): e2012270.
27. Richardson S., et al. “Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area”. JAMA. 323.20 (2020): 2052-2059.
28. Tan E., et al. “Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU: A Systematic Review and Meta-analysis”. Chest2 (2021): 524-536.
29. Zhou F., et al. “Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study”. The Lancet10229 (2020): 1054-1062.
30. Rees EM., et al. “COVID-19 length of hospital stay: A systematic review and data synthesis”. BMC Medicine. BioMed Central Ltd; 18 (2020): 270.
31. Arentz M., et al. “Characteristics and Outcomes of 21 Critically Ill Patients with COVID-19 in Washington State”. JAMA - Journal of the American Medical Association 323 (2020): 1612-1614.
32. Horwitz LI., et al. “Trends in Covid-19 risk-adjusted mortality rates in a single health system”. medRxiv (2020).
33. Dennis JM., et al. “Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020”. Critical Care Medicine2 (2020): 209-214.
34. Ranieri VM., et al. “Acute respiratory distress syndrome: The Berlin definition”. JAMA - Journal of the American Medical Association23 (2012): 2526-2533.
35. Word Health Organization. “Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance”. WHO (2012).
36. Xu W., et al. “Risk factors analysis of COVID-19 patients with ARDS and prediction based on machine learning”. Scientific Reports1 (2021): 2933.
37. Tzotzos SJ., et al. “Incidence of ARDS and outcomes in hospitalized patients with COVID-19: A global literature survey”. Critical Care1 (2020): 1-4.
38. Driggin E., et al. “Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic”. Journal of the American College of Cardiology18 (2020): 2352-2371.
39. Shi S., et al. “Association of Cardiac Injury with Mortality in Hospitalized Patients with COVID-19 in Wuhan, China”. JAMA Cardiology 7 (2020): 802-10.
40. Lippi G., et al. “Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis”. Progress in Cardiovascular Diseases3 (2020): 390-391.
41. Knowlton KU. “Pathogenesis of SARS-CoV-2 induced cardiac injury from the perspective of the virus”. Journal of Molecular and Cellular Cardiology 147 (2020): 12-17.
42. Li X., et al. “Molecular immune pathogenesis and diagnosis of COVID-19”. Journal of Pharmaceutical Analysis 2 (2020) 102-108.
43. Shimizu M. “Clinical Features of Cytokine Storm Syndrome”. In: Cytokine Storm Syndrome. Cham: Springer International Publishing (2019): 31-41.
44. Hirsch JS., et al. “Acute kidney injury in patients hospitalized with COVID-19”. Kidney International 1 (2020): 209-218.
45. Kunutsor SK., et al. “Renal complications in COVID-19: a systematic review and meta-analysis”. Annals of Medicine (2020) 52.7 (2020): 1-9.
46. Robbins-Juarez SY., et al. “Outcomes for Patients With COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis”. Kidney International Reports8 (2020): 1149-1160.
47. Larsen CP., et al. “Collapsing Glomerulopathy in a Patient With COVID-19”. Kidney International Reports6 (2020): 935-939.
48. Su H., et al. “Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China”. Kidney International1 (2020): 219-227.
49. Hoste EAJ., et al. “Global epidemiology and outcomes of acute kidney injury”. Nature Reviews Nephrology10 (2018): 607-625.
50. Kollias A., et al. “Thromboembolic risk and anticoagulant therapy in COVID‐19 patients: emerging evidence and call for action”. British Journal of Haematology5 (2020): 846-847.
51. Kudose S., et al. “Kidney Biopsy Findings in Patients with COVID-19”. Journal of the American Society of Nephrology9 (2020): 1959-1968.
52. Sharma P., et al. “COVID-19-Associated Kidney Injury: A Case Series of Kidney Biopsy Findings”. Journal of the American Society of Nephrology9 (2020): 1948-1958.
53. Rossi GM., et al. “Kidney Biopsy Findings in a Critically Ill COVID-19 Patient With Dialysis-Dependent Acute Kidney Injury: A Case Against ‘SARS-CoV-2 Nephropathy”. Kidney International Reports7 (2021): 1100-1105.
54. Santoriello D., et al. “Postmortem Kidney Pathology Findings in Patients with COVID-19”. Journal of the American Society of Nephrology 9 (2020): 2158-2167.
55. Braun F., et al. “SARS-CoV-2 renal tropism associates with acute kidney injury”. The Lancet 10251 (2020): 597-598.
56. Frontera JA., et al. “A Prospective Study of Neurologic Disorders in Hospitalized Patients With COVID-19 in New York City”. Neurology 4 (2021): e575-586.
57. Barbov I and Kalcev G. “COVID-19 from a Perspective of Neuromuscular Diseases: Meeting the Challenges”. Open Access Macedonian Journal of Medical Sciences1 (2020): 51-51.
58. Malas MB., et al. “Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis”. EClinicalMedicine 29 (2020): 100639.
59. Ciceri F., et al. “Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis”. Critical care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2 (2020): 95-97.
60. Dolhnikoff M., et al. “Pathological evidence of pulmonary thrombotic phenomena in severe COVID‐19”. Journal of Thrombosis and Haemostasis 6 (2020): 1517-1519.
61. Rapkiewicz AV., et al. “Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series”. EClinicalMedicine 24 (2020): 100434.
62. Thachil J., et al. “ISTH interim guidance on recognition and management of coagulopathy in COVID-19”. Journal of Thrombosis and Haemostasis 5 (2020): 1023-1026.
63. Tang N., et al. “Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia”. Journal of Thrombosis and Haemostasis4 (2020): 844-847.
64. American Society of Hematology. “COVID-19 and Coagulopathy: Frequently Asked Questions”. Hematology.org (2021).

65. Ponziani FR., et al. “Liver involvement is not associated with mortality: results from a large cohort of SARS-CoV-2-positive patients”. Alimentary Pharmacology and Therapeutics6 (2020): 1060-1068.

Citation

Citation: Sabah Mohamed Alharazy. “Coronavirus Disease 2019: A Review of Risk Factors, Severity, and Complications”. Acta Scientific Microbiology 4.8 (2021): 41-52.

Copyright

Copyright: © 2021 Sabah Mohamed Alharazy. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.