The complexity of respiratory disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: from immunopathogenesis to respiratory therapy

• Autor(a) principal: Falcão, Luiz Fábio Magno
• Data de Publicação: 2020
• Outros Autores: Pontes, Lucieny da Silva, Silva, Bruno Giovanni Afonso da, Franco, Karen Margarete Vieira da Silva, Costa, Luiz Adriano Araujo da, Rocha, Rodrigo Santiago Barbosa, Quaresma, Juarez Antônio Simões
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Digital do Instituto Evandro Chagas (Patuá)
• DOI: 10.1002/rmv.2167
• Texto Completo: https://patua.iec.gov.br/handle/iec/4179
• topic: Síndrome Respiratória Aguda Grave / imunologia; Vírus da SARS / isolamento & purificação; Coronavirus / patogenicidade; Infecções por Coronavirus; Sistema Nervoso; Lesão Pulmonar / patologia; Manuseio das Vias Aéreas

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.