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

Area of Science:

• Pathophysiology
• Critical Care Medicine
• Immunology

Background:

• Pro-inflammatory processes extend beyond classical inflammation concepts.
• Systemic inflammation (SI) involves microcirculatory abnormalities, encompassing cytokine release and thrombo-inflammatory syndrome.
• Persistent low-grade systemic inflammation (ChSLGI) is linked to severe COVID-19 outcomes.

Purpose of the Study:

• To review the multifaceted nature of inflammation in critical conditions like COVID-19.
• To explore the pathogenetic role of inflammatory systemic microcirculation.
• To examine factors contributing to systemic alteration and SI development in COVID-19.

Main Methods:

• Literature review focusing on inflammation, microcirculation, and COVID-19.
• Analysis of pathogenetic mechanisms in critical illness.
• Examination of risk factors for severe COVID-19.

Main Results:

• Inflammatory systemic microcirculation is central to critical situations, including COVID-19.
• Metabolic syndrome models are insufficient for understanding ChSLGI.
• Hypoxia, metabolic dysfunction, and receptor roles in SI development are examined.

Conclusions:

• Systemic inflammation, driven by microcirculatory dysfunction, is key in COVID-19.
• Understanding ChSLGI and its risk factors is crucial for managing severe COVID-19.
• Further research into hypoxia, metabolic factors, and receptor pathways is warranted.