• Sundareswaran Loganathan, Maheshkumar Kuppusamy, Wankupar Wankhar, Krishna Rao Gurugubelli, Vidyashree Hodagatta Mahadevappa, Lhakit Lepcha, and Arbind Kumar Choudhary.
• Department of Physiology, All India Institute of Medical Science, Mangalagiri, Andhra Pradesh, 522503, India. Electronic address: sundarfinder@gmail.com.
• Respir Physiol Neurobiol. 2021 Jan 1; 283: 103548.

BackgroundGlobally, the current medical emergency for novel coronavirus 2019 (COVID-19) leads to respiratory distress syndrome and death.PurposeThis review highlighted the effect of COVID-19 on systemic multiple organ failure syndromes. This review is intended to fill a gap in information about human physiological response to COVID-19 infections. This review may shed some light on other potential mechanisms and approaches in COVID -19 infections towards systemic multiorgan failure syndromes.FindingSARS-CoV-2 intervened mainly in the lung with progression to pneumonia and acute respiratory distress syndrome (ARDS) via the angiotensin-converting enzyme 2(ACE2) receptor. Depending on the viral load, infection spread through the ACE2 receptor further to various organs such as heart, liver, kidney, brain, endothelium, GIT, immune cell, and RBC (thromboembolism). This may be aggravated by cytokine storm with the extensive release of proinflammatory cytokines from the deregulating immune system.ConclusionThe widespread and vicious combinations of cytokines with organ crosstalk contribute to systemic hyper inflammation and ultimately lead to multiple organ dysfunction (Fig. 1). This comprehensive study comprises various manifestations of different organs in COVID-19 and may assist the clinicians and scientists pertaining to a broad approach to fight COVID 19.Copyright © 2020 Elsevier B.V. All rights reserved.

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