Clinical-Pathological Correlation of the Pathophysiology and Mechanism of Action of COVID-19 - a Primer for Clinicians

Curr Allergy Asthma Rep. 2021 Jul 14;21(6):38. doi: 10.1007/s11882-021-01015-w.

Abstract

Purpose of review: Increasing knowledge of the pathogenesis of the SARS-CoV-2 infection and the complex interaction between host and viral factors have allowed clinicians to stratify the severity of COVID-19 infection. Epidemiological data has also helped to model viral carriage and infectivity. This review presents a comprehensive summary of the pathophysiology of COVID-19, the mechanisms of action of the SARS-CoV-2 virus, and the correlation with the clinical and biochemical characteristics of the disease.

Recent findings: ACE2 and TMPRSS2 receptors have emerged as a key player in the mechanism of infection of SARS-CoV-2. Their distribution throughout the body has been shown to impact the organ-specific manifestations of COVID-19. The immune-evasive and subsequently immunoregulative properties of SARS-CoV-2 are also shown to be implicated in disease proliferation and progression. Information gleaned from the virological properties of SARS-CoV-2 is consistent with and reflects the clinical behavior of the COVID-19 infection. Further study of specific clinical phenotypes and severity classes of COVID-19 may assist in the development of targeted therapeutics to halt progression of disease from mild to moderate-severe. As the understanding of the pathophysiology and mechanism of action of SARS-CoV-2 continues to grow, it is our hope that better and more effective treatment options continue to emerge.

Keywords: COVID-19; Epidemiology; Mechanism of action; Pandemic; Pathogenesis; Pathophysiology.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • COVID-19 / epidemiology
  • COVID-19 / immunology
  • COVID-19 / physiopathology*
  • COVID-19 / virology
  • Disease Progression
  • Humans
  • Immune Evasion
  • Organ Specificity
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity*
  • Serine Endopeptidases / metabolism
  • Severity of Illness Index
  • Virus Internalization

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2
  • Serine Endopeptidases
  • TMPRSS2 protein, human