Pathogenetic justification of the use of hypohyperoxic training in the treatment and prevention of complications of the COVID-19 coronavirus infection

Abstract

The 2019 coronavirus pandemic primarily affects lung tissue and disrupts gas exchange, leading to acute respiratory distress syndrome, systemic hypoxia, and lung damage. The search for methods of prevention and rehabilitation, especially after suffering from pneumonia caused by COVID-19, is on the agenda. Currently, it is known that the COVID-19 virus needs certain conditions from the cell membranes to enter the lung or intestinal cells: the presence of structures that allow the virus to «catch» on the cell (ACE2 receptor), the TMPRSS2 protein structure. Coronaviruses such as SARS-CoV and SARS-CoV-2 are activated by the TMPRSS2 enzyme and, therefore, inhibitors of this enzyme can block the virus. The virus uses APF2 as a receptor to enter the cell, and TMPRSS2 is required for activation of the viral S-protein. Without these structures, the COVID-19 virus cannot enter the cell. It was found that activation of the HIF-1 α-signaling pathway under moderate hypoxia would reduce ACE2 and TMPRSS2 and increase levels of ADAM17 on the alveolocyte surface and, consequently, reduce the invasiveness of SARS-CoV-2. As a result of numerous studies, the possibility of using a new technique, normobaric interval hypo-hyperoxic training, was justified. It was proved that ROS formed during hypoxia-normoxia participate in the initial stages of intracellular redox signaling, which triggers signal transmission to the cell nucleus. As a result, redox signaling leads to saturation of the cell with molecules that increase its protection from damaging effects. It is on these principles that the main provisions for creating a new technique and a new generation of hypoxicator that gives not only hypoxic, but also hyperoxic mixtures were formulated. Interval hypo-hyperoxic training as an effective non-specific method of increasing the body’s defenses is indispensable not only in the prevention of viral infection, but also in rehabilitation after viral pneumonia, as well as as a method that reduces the severity of viral infection in the event of infection.