Department of Cardiac Anesthesiology, Medical University of Gdańsk, Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland.
Department of Medical Immunology, Medical University of Gdansk, Dębinki 1, 80-209 Gdańsk, Poland.
Cardiol J. 2020;27(2):99-114. doi: 10.5603/CJ.a2020.0065. Epub 2020 May 7.
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.
新型冠状病毒 SARS-CoV-2 感染的病理生理学证据正在迅速增加。了解为什么有些 COVID-19 患者病情如此严重,而有些患者则不然,这已成为全球研究人员和临床医生的当务之急。这个问题的答案将使人们能够理性看待这场大流行带来的恐惧。对 COVID-19 病理生理学的理解依赖于对相互作用机制的理解,包括 SARS-CoV-2 的毒力、人体免疫反应以及凝血在其中发挥主要作用的复杂炎症反应。还应检查与细菌合并感染以及整个身体的血管系统和微循环的相互作用。更重要的是,全面了解 COVID-19 的病理机制将提高治疗效果并降低死亡率。在此,介绍了 COVID-19 的最新知识状况:从病毒开始,其传播途径以及进入人体的机制,通过对细胞水平的病理影响,直至免疫反应,全身和器官表现。最后但并非最不重要的是,简要评论了目前可用的和可能的未来治疗和诊断选择。