COVID-19 - Toward a comprehensive understanding of the disease

• Published in: Cardiology journal Vol. 27; no. 2; pp. 99 - 114
• Main Authors: Kowalik, Maciej M, Trzonkowski, Piotr, Łasińska-Kowara, Magdalena, Mital, Andrzej, Smiatacz, Tomasz, Jaguszewski, Miłosz
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 18.05.2020; Via Medica
• Subjects: Antiviral Agents - therapeutic use; Betacoronavirus - drug effects; Betacoronavirus - immunology; Betacoronavirus - pathogenicity; Coronavirus Infections - drug therapy; Coronavirus Infections - immunology; Coronavirus Infections - prevention & control; Coronavirus Infections - transmission; Coronavirus Infections - virology; Coronaviruses; COVID-19; COVID-19 Drug Treatment; COVID-19 Vaccines; Disease transmission; Expert’s Viewpoint; Host-Pathogen Interactions; Humans; Pandemics; Pathophysiology; Pneumonia, Viral - drug therapy; Pneumonia, Viral - immunology; Pneumonia, Viral - transmission; Pneumonia, Viral - virology; Prognosis; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Viral Vaccines - therapeutic use; Virulence; Virus Internalization; COVID-19; epidemiology; SARS-CoV-2; therapy; acute respiratory distress syndrome; coagulation; immunology
• ISSN: 1897-5593; 1898-018X; 1897-5593
• DOI: 10.5603/CJ.a2020.0065

The evidence on the pathophysiology of the novel coronavirus SARS-CoV-2 infection is rapidly growing. Understanding why some patients suffering from COVID-19 are getting so sick, while others are not, has become an informal imperative for researchers and clinicians around the globe. The answer to this question would allow rationalizing the fear surrounding this pandemic. Understanding of the pathophysiology of COVID-19 relies on an understanding of interplaying mechanisms, including SARS-CoV-2 virulence, human immune response, and complex inflammatory reactions with coagulation playing a major role. An interplay with bacterial co-infections, as well as the vascular system and microcirculation affected throughout the body should also be examined. More importantly, a compre-hensive understanding of pathological mechanisms of COVID-19 will increase the efficacy of therapy and decrease mortality. Herewith, presented is the current state of knowledge on COVID-19: beginning from the virus, its transmission, and mechanisms of entry into the human body, through the pathological effects on the cellular level, up to immunological reaction, systemic and organ presentation. Last but not least, currently available and possible future therapeutic and diagnostic options are briefly commented on.