COVID-19 pathogenesis

Prog Mol Biol Transl Sci. 2024:202:67-112. doi: 10.1016/bs.pmbts.2023.07.001. Epub 2024 Jan 5.

Abstract

The pathogenesis of COVID-19 involves a complex interplay between host factors and the SARS-CoV-2 virus, leading to a multitude of clinical manifestations beyond the respiratory system. This chapter provides an overview of the risk factors, genetic predisposition, and multisystem manifestations of COVID-19, shedding light on the underlying mechanisms that contribute to extrapulmonary manifestations. The chapter discusses the direct invasion of SARS-CoV-2 into various organs as well as the indirect mechanisms such as dysregulation of the renin-angiotensin-aldosterone system (RAAS), immune response dysfunctions within the innate and adaptive immune systems, endothelial damage, and immunothrombosis. Furthermore, the multisystem manifestations of COVID-19 across different organ systems, including the cardiovascular, renal, gastrointestinal, hepatobiliary, nervous, endocrine and metabolic, ophthalmic, ear-nose-throat, reproductive, hematopoietic, and immune systems are discussed in detail. Each system exhibits unique manifestations that contribute to the complexity of the disease.

Keywords: ARDS; Extrapulmonary symptoms; Immune dysregulation; Multiorgan manifestations.

MeSH terms

  • COVID-19*
  • Humans
  • Immune System
  • Renin-Angiotensin System / physiology
  • Risk Factors
  • SARS-CoV-2