Complication and Sequelae of COVID-19: What Should We Pay Attention to in the Post-Epidemic Era.

COVID-19 is widespread worldwide and seriously affects the daily life and health of humans. Countries around the world are taking necessary measures to curb the spread. However, COVID-19 patients often have at least one organ complication and sequelae in addition to respiratory symptoms. Controlling the epidemic is only a phased victory, and the complication and sequelae of COVID-19 will need more attention in the post-epidemic era. We collected general information from over 1000 articles published in 2020 after the COVID-19 outbreak and systematically analyzed the complication and sequelae associated with eight major systems in COVID-19 patients caused by ACE2 intervention in the RAS regulatory axis. The autoimmune response induced by 2019-nCoV attacks and damages the normal tissues and organs of the body. Our research will help medical workers worldwide address COVID-19 complication and sequelae.

Extrapulmonary complications of COVID-19: A multisystem disease?

The outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been recently declared a pandemic by the World Health Organization. In addition to its acute respiratory manifestations, SARS-CoV-2 may also adversely affect other organ systems. To date, however, there is a very limited understanding of the extent and management of COVID-19-related conditions outside of the pulmonary system. This narrative review provides an overview of the current literature about the extrapulmonary manifestations of COVID-19 that may affect the urinary, cardiovascular, gastrointestinal, hematological, hematopoietic, neurological, or reproductive systems. This review also describes the current understanding of the extrapulmonary complications caused by COVID-19 to improve the management and prognosis of patients with COVID-19.

Urogenital System Damaging Manifestations of 3 Human Infected Coronaviruses.

PURPOSE: At present, there are no comparative studies on the damage of the 3 coronaviruses infections to the urinary system. Therefore, we reviewed the correlations and differences between invading mechanisms and resultant urogenital system damage by the 3 kinds of coronaviruses in an effort to help doctors in the prevention and treatment of these damages, which will be of significance in improving prognosis and quality of life after rehabilitation. MATERIALS AND METHODS: We searched PubMed® for English language articles published since 2003 with the key words "Coronavirus disease 2019 (COVID-19)," "severe acute respiratory syndrome-2 (SARS-CoV-2)," "severe acute respiratory syndrome (SARS)-CoV" and "Middle East respiratory syndrome (MERS)-CoV "with "semen" and "kidney." We also used relevant data from websites including the World Health Organization and Centers for Disease Control and Prevention. RESULTS: Recent studies have revealed that both SARS-CoV and SARS-CoV-2 invade target cells through a membrane-bound angiotensin-converting enzyme 2, an important component of the renin-angiotensin system, which maintains human homeostasis, whereas MERS utilizes host cells' receptor dipeptidyl peptidase 4 for entry. While pneumonia is the most prominent symptom in patients infected by coronaviruses due to the transmission through respiratory droplets, the urogenital system can also suffer from infection with coronaviruses, resulting in renal failure, testicular atrophy etc. The impairments of the genitourinary system would be different with the 3 coronavirus infections but they still have a strong correlation. CONCLUSIONS: The pathogenesis and clinical symptoms of SARS-CoV, MERS-CoV and SARS-CoV-2 coronaviruses in the genitourinary system are comparable. All 3 coronaviruses have been found to affect kidney and testicular function. Therefore, both urologists and nephrologists should pay attention to the damage caused by coronavirus infection to the genitourinary system, especially monitoring renal and semen function.

A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions.

PURPOSE AND OBJECTIVE: We performed a systematic review on COVID-19 and its potential urological manifestations. METHODS: A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner. RESULTS: There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30-13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46-100%) amongst them. 5.74% (95% CI 2.88-9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71-83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%. CONCLUSIONS: Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures.