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The complexity of respiratory disease associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection: From immunopathogenesis to respiratory therapy
Author(s) -
Falcão Luiz Fábio,
da Silva Pontes Lucieny,
Afonso da Silva Bruno Giovanni,
Vieira da Silva Franco Karen Margarete,
Costa Luiz Adriano,
Barbosa Rocha Rodrigo Santiago,
Simões Quaresma Juarez Antônio
Publication year - 2021
Publication title -
reviews in medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.06
H-Index - 90
eISSN - 1099-1654
pISSN - 1052-9276
DOI - 10.1002/rmv.2167
Subject(s) - medicine , respiratory system , subclinical infection , immunology , disease , pathophysiology , diffuse alveolar damage , severe acute respiratory syndrome , coronavirus , immune system , lung , respiratory disease , pathology , covid-19 , infectious disease (medical specialty) , acute respiratory distress
Summary Covid‐19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, may present with polymorphic symptomatology and subclinical, neurological, gastrointestinal, dermatological, renal and severe acute respiratory manifestations. The diffuse alveolar damage caused by the disease presents with fibrin deposition, oedema, lymphocytic inflammatory infiltrate, destruction of epithelial cells, hyaline membrane formation and occasional angiogenesis formation of microthrombi. A common radiological finding is bilateral ground glass opacity, present even in mild cases. Severe cases occur mainly among the elderly and individuals with underlying comorbidities. Here, we provide an overview of the pathophysiology of the disease associated with SARS‐CoV‐2 infection, interaction of the virus with the immune system, and subsequent dysfunctional immune response, essential for progression of Covid‐19. We also discuss the role of the nervous system as a possible aggravating agent of the respiratory condition and propose a protocol for airway management based on the pathophysiological and immunological characteristics of the disease. Finally, we highlight the implications of such approaches for future therapeutic intervention.