• Jovana Stanoeva University Clinic for Traumatology, Orthopedic Diseases, Anesthesia and Resuscitation, Intensive Care and Emergency Center - Skopje, R. North Macedonia
  • Aleksandar Kisman University Clinic for Traumatology, Orthopedic Diseases, Anesthesia and Resuscitation, Intensive Care and Emergency Center, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia,
  • Snezana Stojkovska University Clinic for Infective diseases- Skopje, Faculty of Medicine,Ss. Cyril and Methodius University in Skopje,R. North Macedonia
  • Vesna Janevska Emergency Medicine Service, PHI Clinical Hospital-Bitola, R. North Macedonia


In 2019, the new coronavirus was identified as the cause of a disease originating from the city of Wuhan in China, now known as SARS-CoV-2. The World Health Organization declared COVID-19 a pandemic in March 2020. Some people may have only a few symptoms or may not have any symptoms at all. Some people may experience worsening symptoms, such as shortness of breath and pneumonia, about a week after the onset of symptoms, and some may experience systemic complications caused by COVID-19 infection. Many of these complications can be caused by a condition known as cytokine release syndrome or cytokine storm. Cytokines can significantly damage vital organ tissue, including the lungs, heart, and kidneys. The pathology of coronavirus disease (COVID-19) is exacerbated by the progression of thrombosis, disseminated intravascular coagulation (DIC), and cytokine storm. Signs and symptoms of an emergency may include: difficulty breathing, rapid, shallow breathing, persistent chest pain or pressure, somnolence, confusion, collapse, pale, gray or blue skin, lips or nails - depending on skin tone. In hospitalized patients, constant monitoring and monitoring of parameters that may indicate a certain complication in the disease requiring prompt timely treatment, is necessary. The following emergency conditions, complications in COVID-19 have been described in this paper: acute respiratory failure, ARDS, COVID-19 coagulopathy and DIC, septic shock, rhabdomyolysis, acute renal failure, acute hepatic failure, acute heart disease, myocarditis, MIS-C, emergency neurological diseases and spontaneous rectus sheath hematoma.

Keywords: emergencies in COVID-19, cytokine storm, COVID-19 coagulopathy, COVID-19 complications, multisystem inflammatory syndrome in children, MIS-C.



1. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020 Apr7;323(13):1239-1242.doi: 10.1001/ jama.2020.2648.
2. Wang D, Hu B, Hu C, Zhu F, Liu X et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17; 323(11): 1061–1069. Published online 2020 Feb 7. doi: 10.1001/jama.2020.1585
3. Web MD, Complications Coronavirus can cause. www.webmd.com/lung/coronavirus-complications#1-2
4. Xu Li, Xiaochun Ma. Acute respiratory failure in COVID-19: is it "typical" ARDS? Crit Care. 2020 May 6; 24 (1):198. doi: 10.1186/s13054-020-02911-9.
5. Johns Hopkins medicine. COVID-19 Lung Damage. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs.
6. Peter G Gibson, Ling Qin, Ser Hon Puah. COVID‐19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre‐COVID‐19 ARDS. Med J Aust. 2020 Jul;213(2):54-56.e1. doi: 10.5694/mja2.50674. Epub 2020 Jun 22.
7. Marcel Levi and Toshiaki Iba. COVID-19 coagulopathy: is it disseminated intravascular coagulation? Intern Emerg Med. 2021; 16(2): 309–312. Published online 2020 Dec 24. doi: 10.1007/s11739-020-02601-y.
8. Alexander D. Makatsariya1 , Кristina N. Grigorieva1 , Marat A. Mingalimov1 , Viktoria O. et al. . Coronavirus disease (COVID-19) and disseminated intravascular coagulation. Sechenov university. Vol 14, No 2 (2020) https://doi.org/10.17749/2313-7347.132
9. Hidesaku Asakura and Haruhiko Ogawa. COVID-19-associated coagulopathy and disseminated intravascular coagulation. Int J Hematol. 2020 Nov 7 : 1–13.doi: 10.1007/s12185-020-03029-y.
10. Beltrán-García J, Osca-Verdegal R, Pallardó F. V. et al. Sepsis and Coronavirus Disease 2019: Common Features and Anti-Inflammatory Therapeutic Approaches. Crit Care Med. 2020 Sep 1 .Published online 2020 Aug 21. doi: 10.1097/CCM.0000000000004625.
11. Sreenath Meegada, Vijayadershan Muppidi, Donald C Wilkinson, Suman Siddamreddy, and Shravan K Katta .Coronavirus Disease 2019-Induced Rhabdomyolysis. Cureus. 2020 Aug; 12(8): e10123.Published online 2020 Aug 29. doi: 10.7759/cureus.10123.
12. Prof Claudio Ronco, MD .Thiago Reis, MD.Faeq Husain-Syed, MD. Management of acute kidney injury in patients with COVID-19. VIEWPOINT| VOLUME 8, ISSUE 7, P738-742, JULY 01, 2020 Published:May 14, 2020DOI:https://doi.org/10.1016/S2213-2600(20)30229-0
13. Johns Hopkins medicine. Coronavirus: Kidney Damage Caused by COVID-19 https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19
14. Tarragón B, Valdenebro M, Serrano ML, Maroto A, Llópez-Carratalá MR, Ramos A, et al. Acute kidney failure in patients admitted due to COVID-19. Nefrología (English Edition). 2021;41(1):34-40. DOI:10.1016/j.nefroe.2020.08.005
15. Dhineshreddy Gurala,. Hassan Al Moussawi. Jobin Philipose, and Jeffrey R Abergel. Acute Liver Failure in a COVID-19 Patient Without any Preexisting Liver Disease. Cureus. 2020 Aug; 12(8): e10045.Published online 2020 Aug 26. doi: 10.7759/cureus.10045.
16. Salvatore Pepe, Ann T. Gregory, MBBS, GradCertPopHealth, and A. Robert Denniss. Myocarditis, Pericarditis and Cardiomyopathy After COVID-19 Vaccination. Heart Lung Circ. 2021 Oct; 30(10): 1425–1429.
17. Ángela Irabien-Ortiza, José Carreras-Morab, Alessandro Sionisb, Julia Pàmiesb, José Montiela, Manel Taurona. Fulminant myocarditis due to COVID-19. Revista espanola de cardiologia Vol. 73. Issue 6. pages 503-504 (June 2020) DOI: 10.1016/j.rec.2020.04.005.
18. Ranard L. S., Fried J.A., Abdalla M., AnsteyD. E., Givens R. C., Kumaraiah D., Susheel K. et al. Approach to Acute Cardiovascular Complications in COVID-19Infection. Circ Heart Fail. 2020 Jul;13(7):e007220. doi: 10.1161/CIRCHEARTFAILURE.120.007220.
19. Massimo Imazio. COVID-19 as a Possible Cause of Myocarditis and Pericarditis. American college of cardiology. Feb 05, 2021. Expert Analysis.
https://www.acc.org/latest-in cardiology/articles/2021/02/05/19/37/covid-19-as-a-possible-cause-of-myocarditis-and-pericarditis
20. Angelo Valerio Marzano, Nicoletta Cassano, Chiara Moltrasio, Lucio Verdonie Giovanni Genovese, Gino Antonio Vena. Multisystem Inflammatory Syndrome in Children Associated with COVID-19: A Review with an Emphasis on Mucocutaneous and Kawasaki Disease-Like Findings. Dermatology. 2021 Jun 1;1-9. doi: 10.1159/000515449.
21. Johns Hopkins medicine. MIS-C and COVID-19: Rare Inflammatory Syndrome in Kids and Teens https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/misc-and-covid19-rare-inflammatory-syndrome-in-kids-and-teens.
22. Mayo Clinic. Multisystem inflammatory syndrome in children (MIS-C) and COVID-19 https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-20502550
23. Julie G. Shulman, Thomas Ford, and Anna M. Cervantes-Arslanian,. Neurologic Emergencies during the Coronavirus Disease 2019 Pandemic. Neurol Clin. 2021 May; 39(2): 671–687.Published online 2021 Mar 26. doi: 10.1016/j.ncl.2021.02.007.
24. Vahid Reisi-Vanani, Zahra Lorigooini, Mohamad Ali Dayani, Mehrandokht Mardani & Fereidoun Rahmani. Massive intraperitoneal hemorrhage in patients with COVID-19: a case series. J Thromb Thrombolysis 2021 Apr 28 : 1–7. doi: 10.1007/s11239-021-02447-x.
25. Behzad Nematihonar, Shohra Qaderi, Jaffer Shah & Javad zebarjadi Bagherpour. Spontaneous giant rectus sheath hematoma in patients with COVID-19: two case reports and literature review. BMC International Journal of Emergency Medicine (2021) 14:40. https://doi.org/10.1186/s12245-021-00366-5.
How to Cite
STANOEVA, Jovana et al. EMERGENCIES IN CORONAVIRUS DISEASE CAUSED BY COVID-19 VIRUS. Journal of Morphological Sciences, [S.l.], v. 4, n. 3, p. 64-75, dec. 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/vol4no3-10>. Date accessed: 27 feb. 2024.