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17 June 2022 : Case report  

[In Press] Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Aleksandra Barbachowska1EF, Jolanta Gozdowska1AE, Dorota Piotrowska-Kownacka2C, Monika Sawicka2D, Dominika Dęborska-Materkowska1A, Ewa Skolimowska1F, Magdalena Durlik1A

DOI: 10.12659/AOT.935874

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

Available online: 2022-06-17, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


COVID-19 disease, caused by the SARS-CoV-2 virus, has been one of the greatest challenges in modern medicine. It is mostly known to affect the pulmonary system, leading to pneumonia and acute respiratory distress syndrome, but there is a growing body of evidence of extrapulmonary manifestations of COVID-19 disease.
This article presents 3 cases of various extrapulmonary symptoms of COVID-19 disease and a literature review of similar clinical cases. Two patients had a medical history of living-donor kidney transplantation, and 1 patient was a kidney donor. We present symptoms, diagnostic processes, laboratory and imaging results, and treatment approach.
Patient 1 was 29-year-old woman with new-onset diabetes mellitus due to SARS-CoV-2, which required temporary insulin treatment.
Patient 2 was a 34-year-old man with fever, chronic fatigue, back pain, and abdominal pain. Imagining showed acalculous cholecystitis, epiploic appendagitis of the right colic flexure, and inflammation of pericardial fat pad in the left cardiophrenic angle. Coagulopathy due to COVID-19 was the most probable cause of the described processes. Therapeutic doses of low-molecular-weight heparin were administered.
Patient 3 was a 68-year-old male kidney donor who had painless, nodular, reddening lesions on both shins, accompanied by itching on both shins and recurrent fever. The diagnosis of erythema nodosum during COVID-19 was made. After treatment with low-molecular-weight heparin, significant decreases of symptoms were observed.
We conclude that SARS-CoV-2 infection can have a varied course and can involve other systems and organs. Physicians should be aware of possible extrapulmonary symptoms associated with infection with this virus. Correct diagnosis is a prerequisite for proper treatment and prevention of unexpected complications.

Keywords: COVID-19; SARS-CoV-2; Transplantation; Extrapulmonary Manifestations; Kidney Transplant


17 June 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

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Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358