期刊
LANCET RESPIRATORY MEDICINE
卷 9, 期 6, 页码 622-642出版社
ELSEVIER SCI LTD
DOI: 10.1016/S2213-2600(21)00218-6
关键词
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资金
- Poland National Science Centre [UMO-2020/01/0/NZ6/00218]
- UK National Institute for Health Research (NIHR) Clinician Scientist Award [CS-2016-16-011]
- Berlin Institute of Health (BIH) Charite Clinician Scientist Programme
- Charite-Universitatsmedizin Berlin
- Berlin Institute of Health
- Deutsche Forschungsgemeinschaft [SFB 1278, 316213987]
- Netherlands Organisation for Scientific Research
- CIBERES in the context of CIBERESUCICOVID (Instituto de Salud Carlos III)
- Ministero della Salute, Bando Ricerca COVID-19 [COVID-2020-12371808]
The zoonotic SARS-CoV-2 virus causing COVID-19 has devastating consequences worldwide, affecting primarily the respiratory system but also leading to long-term complications. Understanding the pathophysiology and immune response of COVID-19 is crucial for optimizing patient care and treatment strategies.
The zoonotic SARS-CoV-2 virus that causes COVID-19 continues to spread worldwide, with devastating consequences. While the medical community has gained insight into the epidemiology of COVID-19, important questions remain about the clinical complexities and underlying mechanisms of disease phenotypes. Severe COVID-19 most commonly involves respiratory manifestations, although other systems are also affected, and acute disease is often followed by protracted complications. Such complex manifestations suggest that SARS-CoV-2 dysregulates the host response, triggering wide-ranging immuno-inflammatory, thrombotic, and parenchymal derangements. We review the intricacies of COVID-19 pathophysiology, its various phenotypes, and the anti-SARS-CoV-2 host response at the humoral and cellular levels. Some similarities exist between COVID-19 and respiratory failure of other origins, but evidence for many distinctive mechanistic features indicates that COVID-19 constitutes a new disease entity, with emerging data suggesting involvement of an endotheliopathy-centred pathophysiology. Further research, combining basic and clinical studies, is needed to advance understanding of pathophysiological mechanisms and to characterise immuno-inflammatory derangements across the range of phenotypes to enable optimum care for patients with COVID-19.
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