Extrapulmonary manifestations and complications of severe acute respiratory syndrome coronavirus 2 infection: a systematic review

Introduction: We aimed to describe the extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including their frequency, onset with respect to respiratory symptoms, pathogenesis and association with disease severity. Methods: We searched the MEDLINE and Embase databases for SARS-CoV-2-related studies. Meta-analysis, observational studies, case series and case reports published in English or Chinese between 1 January and 1 May 2020 were included. Reports with only paediatric or obstetric cases were excluded. Results: 169 articles were included. Early manifestations (preceding respiratory symptoms until Day 6 of onset) included olfactory and gustatory disturbance (self-reported in up to 68% and 85% of cases, respectively), gastrointestinal symptoms (up to 65.9%) and rash (up to 20.4%). From Day 7 onwards, hypercytokinaemia, paralleled multi-organ complications including acute cardiac injury (pooled incidence of 17.7% in 1,412 patients, mostly with severe disease and 17.4% mortality), kidney and liver injury (up to 17% and 33%, respectively) and thrombocytopenia (up to 30%). Hypercoagulability resulted in venous thromboembolic events in up to 31% of all patients. Uncommon disease presentation and complications comprised Guillain-Barré syndrome, rhabdomyolysis, otitis media, meningoencephalitis and spontaneous pneumomediastinum. Conclusion: Although the systemic manifestations of SARS-CoV-2 infection are variegated, they are deeply interwoven by shared mechanisms. Two phases of extrapulmonary disease were identified: (a) an early phase with possible gastrointestinal, ocular and cutaneous involvement and (b) a late phase characterised by multiorgan dysfunction and clinical deterioration. A clear, multidisciplinary consensus to define and approach thromboinflammation and cytokine release syndrome in SARS-CoV-2 is needed.</jats:p

Adding coral rubble to substrata enhances settlement of Pocillopora damicornis larvae

10.1007/s00338-009-0467-yCoral Reefs282529-533CORF

Integrated Assessment of Heavy Metal Pollution in the Surface Sediments of the Laizhou Bay and the Coastal Waters of the Zhangzi Island, China: Comparison among Typical Marine Sediment Quality Indices

The total concentrations and chemical forms of heavy metals (Cd, Cr, Cu, Ni, Pb and Zn) in the surface sediments of the Laizhou Bay and the surrounding marine area of the Zhangzi Island (hereafter referred to as Zhangzi Island for short) were obtained and multiple indices and guidelines were applied to assess their contamination and ecological risks. The sedimentary conditions were fine in both of the two studied areas according to the marine sediment quality of China. Whereas the probable effects level guideline suggested that Ni might cause adverse biological effects to occur frequently in some sites. All indices used suggested that Cd posed the highest environmental risk in both the Laizhou Bay and the Zhangzi Island, though Cd may unlikely be harmful to human and ecological health due to the very low total concentrations. The enrichment factor (EF) showed that a substantial portion of Cr was delivered from anthropogenic sources, whereas the risk assessment code (RAC) indicated that most Cr was in an inactive state that it may not have any adverse effect either. Moreover, the results of EF and geoaccumulation index were consistent with the trend of the total metal concentrations except for Cd, while the results of RAC and potential ecological risk factor did not follow the same trend of their corresponding total metal concentrations. We also evaluated the effects of using different indices to assess the environmental impact of these heavy metals