Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection

Clin Microbiol Rev. 2021 Jan 13;34(2):e00133-20. doi: 10.1128/CMR.00133-20. Print 2021 Mar 17.


To date, seven identified coronaviruses (CoVs) have been found to infect humans; of these, three highly pathogenic variants have emerged in the 21st century. The newest member of this group, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected at the end of 2019 in Hubei province, China. Since then, this novel coronavirus has spread worldwide, causing a pandemic; the respiratory disease caused by the virus is called coronavirus disease 2019 (COVID-19). The clinical presentation ranges from asymptomatic to mild respiratory tract infections and influenza-like illness to severe disease with accompanying lung injury, multiorgan failure, and death. Although the lungs are believed to be the site at which SARS-CoV-2 replicates, infected patients often report other symptoms, suggesting the involvement of the gastrointestinal tract, heart, cardiovascular system, kidneys, and other organs; therefore, the following question arises: is COVID-19 a respiratory or systemic disease? This review aims to summarize existing data on the replication of SARS-CoV-2 in different tissues in both patients and ex vivo models.

Keywords: COVID-19; SARS-CoV-2; coronavirus; disease; infection; organoids; organs; systemic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / physiopathology*
  • China / epidemiology
  • Humans
  • Middle East Respiratory Syndrome Coronavirus / pathogenicity*
  • Pandemics
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / physiopathology*
  • SARS-CoV-2 / pathogenicity*