Problems of Pathogenesis and Pathogenetic Therapy of COVID-19 from the Perspective of the General Theory of Pathological Systems (General Pathological Processes)

• Published in: International journal of molecular sciences Vol. 22; no. 14; p. 7582
• Main Authors: Gusev, Evgenii, Sarapultsev, Alexey, Hu, Desheng, Chereshnev, Valeriy
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 15.07.2021; MDPI
• Subjects: Abnormalities; ARDS; Chemokines; Coronaviruses; COVID-19; Cytokine storm; Cytokines; Endothelium; Epidemics; general pathological process; Health care; Hemophagocytic syndrome; Hospitals; Hypoxia; Infections; Inflammation; Inflammatory response; low-grade inflammation; Metabolic disorders; Metabolic syndrome; Metabolism; microcirculation; MODS; Mortality; Multiple organ dysfunction syndrome; Pathogenesis; Patients; Pattern recognition; Pneumonia; Respiratory diseases; Review; Risk analysis; Risk factors; Scavenger receptors; Severe acute respiratory syndrome coronavirus 2; Viral infections
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms22147582

The COVID-19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries. Pro-inflammatory processes extend far beyond the classical concepts of inflammation. They manifest themselves in a variety of ways, beginning with extreme physiology, then allostasis at low-grade inflammation, and finally the shockogenic phenomenon of “inflammatory systemic microcirculation”. The pathogenetic core of critical situations, including COVID-19, is this phenomenon. Microcirculatory abnormalities, on the other hand, lie at the heart of a specific type of general pathological process known as systemic inflammation (SI). Systemic inflammatory response, cytokine release, cytokine storm, and thrombo-inflammatory syndrome are all terms that refer to different aspects of SI. As a result, the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low-grade systemic inflammation (ChSLGI). Diseases associated with ChSLGI, on the other hand, are risk factors for a severe COVID-19 course. The review examines the role of hypoxia, metabolic dysfunction, scavenger receptors, and pattern-recognition receptors, as well as the processes of the hemophagocytic syndrome, in the systemic alteration and development of SI in COVID-19.