COVID-19. Understanding of the consequences

Abstract

The new coronavirus infection known as SARS‑CoV‑2 and firstly registered in Wuhan, China in late 2019, resulted in the severe crisis and a great number of lethal outcomes worldwide. Processes occurring in a body with virus infecting are quite polymorphic and involve all organs and systems. The first step in the infection is the virus binding with the host cell via target ACE‑2 receptors with resulting virus‑inducted down‑regulation of these receptors which, through a number of signaling pathways, leads to COVID‑related damage to an organ or system. Since ACE‑2 receptors play a leading role as an entrance gate for the virus, understanding of an axis of ACE/angiotensin receptor and ACE‑2/MAS‑receptor has the crucial significance in the investigation of infection role. The article presents review of the data from patients with delayed recovery after COVID‑19. The prolonged disease duration and disability are often inherent to the patients, hospitalized due to severe and critically severe disease forms. There is no universally accepted definition of «Long Covid», or post‑covid syndrome, but for convenience it was conditionally distinguished a subacute condition that lasts more than 3 weeks from the onset of the disease, and a chronic condition that lasts more than 12 weeks. Among the pathogenetic peculiarities, the activation of renin‑angiotensin‑aldosterone system, cytokine system, anti/prooxidant stress, coagulopathy, endothelial disfunction have been examined. Better understanding of the mechanisms that are realized at COVID‑19, will enable the rational use of the medicines for the disease treatment on all stages that may possibly prevent complications and prolonged consequences of the infection as well as improve the quality of life of patients.