Extrapulmonary Manifestations of COVID-19: A Call to Extra Vigilance and Tribute to Dr Li Wenliang
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COVID-19 pandemic has covered all continents and virtually all countries of the world infecting millions of people with several hundred thousands of death. It was first brought to the attention of a Chinese ophthalmologist Dr Li Wenliang. The disease which was first believed to be solely associated with the lungs and respiratory system has now shown that the spectrum of organ involvement of the disease is much larger than earlier believed. While lung and pulmonary features still account for a much larger presentation of the disease, other clinical manifestations such as fulminant myocarditis, arteriovenous thromboembolism, disseminated intravascular coagulopathy, intracerebral haemorrhage, diarrhea, hypoxic encephalopathy, septicaemia and detection of SARS-CoV-2 particles in stool, saliva and semen of infected individuals are also becoming less infrequent. Haematologic manifestations of hypercoagulable blood are commonly reported among hospitalized COVID‐19 patients. An elevated D‐Dimer, that is rising in the course of disease may signifies disease deterioration. Prolonged PT and aPTT and increased fibrin degradation products with severe thrombocytopenia have been associated with life-threatening disseminated intravascular coagulation (DIC). Physicians should therefore be on a watch out for these features in the management of patients and be ready to spot out other new surprises by the disease. This should be through deepening of curiosity by health personnel in the assessment and management of patients to spot out early surprises of COVID-19 to strengthen the sustenance of the ongoing control of the pandemic
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Peterson E, Hui D, Hamer DH. Li Wenliang, a face to the frontline healthcare worker. The first doctor to notify the emergence of the SARS-CoV-2, (COVID-19), outbreak. Int J Infect Dis. 2020; (93): 205-207. DOI:https://doi.org/10.1016/j.ijid.2020.02.052. DOI: https://doi.org/10.1016/j.ijid.2020.02.052
Yi Y, Lagniton PNP, Ye S, Li E, Xu RH. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020; 16(10):1753-1766. doi:10.7150/ijbs.45134. Available from http://www.ijbs.com/v16p1753.htm. DOI: https://doi.org/10.7150/ijbs.45134
Rabi FA, Al Zoub MS, Kasasbeh GA, et al. SARS-CoV-2 and Coronavirus Disease 2019: What We Know So Far. Pathogens 2020, 9(3), 231; https://doi.org/10.3390/pathogens9030231. DOI: https://doi.org/10.3390/pathogens9030231
Lee EYP, Ng MY, Khong PL. COVID-19 pneumonia: what has CT taught us? Lancet Infect Dis. 2020; 20(4): 384-385. DOI:https://doi.org/10.1016/S1473-3099(20)30134-1. DOI: https://doi.org/10.1016/S1473-3099(20)30134-1
Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Apr 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020; https://www.ncbi.nlm.nih.gov/books/NBK554776/.
Adhikari, S., Meng, S., Wu, Y. et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty. 2020; 9(29): https://doi.org/10.1186/s40249-020-00646-x. DOI: https://doi.org/10.1186/s40249-020-00646-x
Tian S, Hu W, Niu L, et al. Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients With Lung Cancer. J Thoracic Oncol. 2020; 15(5): 700-704. https://doi.org/10.1016/j.jtho.2020.02.010. DOI: https://doi.org/10.1016/j.jtho.2020.02.010
Vetter P, Vu Diem L, L'Huillier AG, et al. Clinical features of covid-19. BMJ 2020; 369: :m1470. doi: https://doi.org/10.1136/bmj.m1470. DOI: https://doi.org/10.1136/bmj.m1470
Jombo GTA, Mbaawuaga EM, Ayegba AS, Enenebeaku MNO, Okwori EE, Peters EJ, Akpan S, Odey F, Gyuse AN. How far have we rolled back malaria on the African continent nine years down: The burden of malaria among pregnant women in a semi-urban community of northern Nigeria. J of Med and Med Sci. 2010; 1(6): 235-241. http://www.academicjournals.org/IJMMS.
Jombo GT, Mbaawuaga EM, Ahmed U, Abba PO. Patterns of Widal test results among patients suspected to have typhoid fever attending BSUTH Makurdi Nigeria. Int J Health Sci Res. 2019; 9(1):6-12. www.http://www.ijhsr.org.
Jombo GTA, Denen Akaa P, Banwat EB, Dauda MA. A review of literature on unusual clinical presentations and potential challenges in diagnosis of histoplasmosis. J of Clin Medi and Research 2010; 2(10): 159-160. http://www.academicjournals.org/JCMR.
Jombo GTA, Mbaawuaga EM, Denen-Akaa P, Alao OO, Peters EJ, Utsalo SJ, Okwori EE, Akosu TJ, Etukumana EA. Socio-cultural factors influencing the control of malaria in an endemic city in north central Nigeria. Int J of Biol and Med Research 2010; 1(4): 172-176. http://www.biomedscidirect.com/articles.php.
Sharifi-Razavi A, Karimi N, Rouhani N. COVID-19 and intracerebral haemorrhage: causative or coincidental. New Microbes & New Infections. 2020; 35©: 100669. DOI: https://doi.org/10.1016/j.nmni.2020.100669
Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifeststions and potential faecal-oral transmission. Gastroenterol. 2020; 158: 1518-1519. DOI: https://doi.org/10.1053/j.gastro.2020.02.054
Chen T, Wu D, Chen H, Yan W, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020; 368: m1091. DOI: https://doi.org/10.1136/bmj.m1091
Zeng JH, Liu YX, Yuan J, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights [published online ahead of print. Infection. 2020;1‐5. doi: https://www.10.1007/s15010-020-01424-5. DOI: https://doi.org/10.1007/s15010-020-01424-5
Lodigiani C, Lepichino G, Carenzo L, et al.Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis Resaerc 2020; 191: 9-14. DOI: https://doi.org/10.1016/j.thromres.2020.04.024
Rana P. Coronavirus Is Found in Semen of Covid-19 Patients. Wall Street J. https://www.wsj.com/articles/coronavirus-is-found-in-semen-of-covid-19-patients-11588863600. Acessed 8th May, 2020.
Greenwood M. Saliva samples preferable to deep nasal swabs for testing COVID-19. YaleNews. https://news.yale.edu/2020/04/24/saliva-samples-preferable-deep-nasal-swabs-testing-covid-19. Accessed 8th May, 2020.
Terpos, E, Ntanasis‐Stathopoulos, I, Elalamy, I, et al. Hematological findings and complications of COVID‐19. Am J Hematol. 2020; 1– 14. https://doi.org/10.1002/ajh.25829 DOI: https://doi.org/10.1002/ajh.25829