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Complex mechanism of COVID-19 development


Coronavirus infection (COVID-19) is an acute viral disease, which affects all vital organs and is caused by an RNA-genomic virus of the genus Betacoronavirus of the family Coronaviridae. This virus (SARS-CoV-2) enters the body through the respiratory tract and interacts primarily with Toll-like receptors of epithelial cells of the bronchi, alveoli, intestines and vascular endotheliocytes, as well as with angiotensin-converting enzyme 2 receptors. Toll-like receptors activate nuclear factor Kappa B in these cells, which initiates the formation of many cytokines (“cytokine storm”). SARS-CoV-2 affects type II pneumocytes by causing a termination of surfactant formation and, accordingly, alveolar shrinking and the formation of acute respiratory distress syndrome and also fibrosis on the interalveolar-capillary membrane and the formation of acute respiratory failure. SARS-CoV-2 and cytokines disrupt the function of vascular endothelial cells, which leads to endothelial dysfunction. In microvessels forms a mass formation of microthrombi, which causes the failure of organs and systems. “Cytokine storm” turns into cytokine sepsis with the formation of multiple organ dysfunction syndrome.

About the Authors

S. B. Bolevich
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Sergey B. Bolevich, MD, PhD, DMSc, Professor, Head of the Human Pathology Department

8/2, Trubetskaya str., Moscow, 119991

S. S. Bolevich
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Stefani S. Bolevich, Assistant Professor, Pathophysiology Department

8/2, Trubetskaya str., Moscow, 119991


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