The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity
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 phenotype...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
June 2021
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| In: |
The lancet. Respiratory medicine
Year: 2021, Jahrgang: 9, Heft: 6, Pages: 622-642 |
| ISSN: | 2213-2619 |
| DOI: | 10.1016/S2213-2600(21)00218-6 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S2213-2600(21)00218-6 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S2213260021002186 
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| Verfasserangaben: | Marcin F Osuchowski, Martin S Winkler, Tomasz Skirecki, Sara Cajander, Manu Shankar-Hari, Gunnar Lachmann, Guillaume Monneret, Fabienne Venet, Michael Bauer, Frank M Brunkhorst, Sebastian Weis, Alberto Garcia-Salido, Matthijs Kox, Jean-Marc Cavaillon, Florian Uhle, Markus A Weigand, Stefanie B Flohé, W Joost Wiersinga, Raquel Almansa, Amanda de la Fuente, Ignacio Martin-Loeches, Christian Meisel, Thibaud Spinetti, Joerg C Schefold, Catia Cilloniz, Antoni Torres, Evangelos J Giamarellos-Bourboulis, Ricard Ferrer, Massimo Girardis, Andrea Cossarizza, Mihai G Netea, Tom van der Poll, Jesús F Bermejo-Martín, Ignacio Rubio |
MARC
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| 245 | 1 | 4 | |a The COVID-19 puzzle |b deciphering pathophysiology and phenotypes of a new disease entity |c Marcin F Osuchowski, Martin S Winkler, Tomasz Skirecki, Sara Cajander, Manu Shankar-Hari, Gunnar Lachmann, Guillaume Monneret, Fabienne Venet, Michael Bauer, Frank M Brunkhorst, Sebastian Weis, Alberto Garcia-Salido, Matthijs Kox, Jean-Marc Cavaillon, Florian Uhle, Markus A Weigand, Stefanie B Flohé, W Joost Wiersinga, Raquel Almansa, Amanda de la Fuente, Ignacio Martin-Loeches, Christian Meisel, Thibaud Spinetti, Joerg C Schefold, Catia Cilloniz, Antoni Torres, Evangelos J Giamarellos-Bourboulis, Ricard Ferrer, Massimo Girardis, Andrea Cossarizza, Mihai G Netea, Tom van der Poll, Jesús F Bermejo-Martín, Ignacio Rubio |
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| 520 | |a 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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