THE VIEW OF THE CLINICIAN ON THE PROBLEM OF COVID-19: review

Abstract

The review article features the peculiarities in the epidemiological and clinical picture of a new coronavirus infection, COVID-19. The purpose of the review was to analyze the issues of the management. Pathogenetic relationships between SARS-CoV-2 virus, COVID-19 and angiotensin-converting enzyme 2 (ACE2) are assessed. Predisposing factors, which result in development of pneumonia and endothelial dysfunction, disorders in microcirculation, vasocon- striction, work of the renin-angiotensin system with subsequent development of ischemia in certain organs, inflammation and edema of tissues, are analyzed. Lung damage causes devel- opment of interstitial pneumonia, activation of the process of formation of fibrosis and de- creased pulmonary function. Accumulation of anti-inflammatory cytokines, which break the blood-brain barrier, in the CNS can cause dysregulation of central structures, autonomic dysfunction and severe asthenic syndrome, which can maintain low-grade inflammation for a long time. Opportune diagnosis and treatment of concomitant diseases in post-COVID-19 patients are of paramount significance for achieving a positive clinical outcome. The plan of rehabilitation treatment should be individualized according to the patient’s needs. In order to assess remote consequences of COVID-19 all patients require further follow-ups.