Clinical Manifestation and Disease Progression in COVID-19 Infection.

Tsai, Ping-Hsing; Lai, Wei-Yi; Lin, Yi-Ying; Luo, Yung-Hung; Lin, Yi-Tsung; Chen, Hsiao-Kang; Chen, Yuh-Min; Lai, Yi-Chun; Kuo, Li-Chiao; Chen, Shew-Dan; Chang, Kao-Jung; Liu, Cheng-Hsuan; Chang, Shih-Chieh; Wang, Fu-Der; Yang, Yi-Ping

COVID-19 is mainly an infectious disease of the respiratory system transmitted through air droplets and pulmonary symptoms constitute main presentations of this disease. However, COVID-19 demonstrates a clinically diverse manifestation ranging from asymptomatic presentation to critically illness with severe pneumonia, acute respiratory distress syndrome, respiratory failure, or multiple organ failure. Accumulating evidences demonstrated that COVID-19 has extrapulmonary involvement, including neurological, smelling sensation, cardiovascular, digestive, hepatobiliary, renal, endocrinologic, dermatologic system, and others. Over a third of COVID-19 patients manifest a wide range of neurological symptoms involving the central/peripheral nervous system. Underlying cardiovascular comorbidities were associated with detrimental outcomes, meanwhile the occurrence of cardiovascular complications correlate to poor survival. Gastrointestinal symptoms frequently occur and have been associated with a longer period of illness. Impaired hepatic functions were associated with the severity of the disease. Higher rate of acute kidney injury was reported in critically ill patients with COVID-19. Endocrinologic presentations of COVID-19 include exacerbating hyperglycemia, euglycemic ketosis and diabetic ketoacidosis. The most common cutaneous manifestation was acro-cutaneous (pernio or chilblain-like) lesions, and other skin lesions consist of maculopapular rash, vesicular lesions, livedoid/necrotic lesions, exanthematous rashes, and petechiae. This review article summarized the general clinical signs and symptoms, radiologic features, and disease manifestation with progression in patients with COVID-19.