• Philip A Verhoef, Sujatha Kannan, Jamie L Sturgill, Elizabeth W Tucker, Peter E Morris, Andrew C Miller, Travis R Sexton, Jay L Koyner, Rana Hejal, Scott C Brakenridge, Lyle L Moldawer, Richard S Hotchkiss, Teresa M Blood, Monty B Mazer, Scott Bolesta, Sheila A Alexander, Donna Lee Armaignac, Steven L Shein, Christopher Jones, Caroline D Hoemann, Allan Doctor, Stuart H Friess, Robert I Parker, Alexandre T Rotta, and Kenneth E Remy.
• Department of Medicine, University of Hawaii-Manoa, Honolulu, HI.
• Crit Care Explor. 2021 Mar 1; 3 (3): e0374.

ObjectivesSince the beginning of the coronavirus disease 2019 pandemic, hundreds of thousands of patients have been treated in ICUs across the globe. The severe acute respiratory syndrome-associated coronavirus 2 virus enters cells via the angiotensin-converting enzyme 2 receptor and activates several distinct inflammatory pathways, resulting in hematologic abnormalities and dysfunction in respiratory, cardiac, gastrointestinal renal, endocrine, dermatologic, and neurologic systems. This review summarizes the current state of research in coronavirus disease 2019 pathophysiology within the context of potential organ-based disease mechanisms and opportunities for translational research.Data SourcesInvestigators from the Research Section of the Society of Critical Care Medicine were selected based on expertise in specific organ systems and research focus. Data were obtained from searches conducted in Medline via the PubMed portal, Directory of Open Access Journals, Excerpta Medica database, Latin American and Caribbean Health Sciences Literature, and Web of Science from an initial search from December 2019 to October 15, 2020, with a revised search to February 3, 2021. The medRxiv, Research Square, and clinical trial registries preprint servers also were searched to limit publication bias.Study SelectionContent experts selected studies that included mechanism-based relevance to the severe acute respiratory syndrome-associated coronavirus 2 virus or coronavirus disease 2019 disease.Data ExtractionNot applicable.Data SynthesisNot applicable.ConclusionsEfforts to improve the care of critically ill coronavirus disease 2019 patients should be centered on understanding how severe acute respiratory syndrome-associated coronavirus 2 infection affects organ function. This review articulates specific targets for further research.Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

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