Complications in COVID-19 patients. Suggested mechanisms of correction

The review evidences the imbalance in innate and adaptive immunity in severely ill patients with COVID-19. In this case, the complement system is activated, the relationship between individual subpopulations of T-lymphocytes is disrupted, and the content of pro-inf ammatory cytokines and chemokines increases, thus leading to the development of the so-called «cytokine storm». At the same time, there occurs a hypercoagulation, accompanied by an increase in the expression of tissue and von Willebrand factors on the blood vessel endothelium, increased platelet aggregation, and an increase in the D-dimer and f brinogen/f brin degradation products. These processes are concomitant with the development of microangiopathy, immunothrombosis, disseminated intravascular coagulation and multiple organ failure. Under the inf uence of the virus and the developed immunity and hemostasis shifts, complications in the following systems and organs may occur: respiratory system (pneumonia, acute respiratory distress syndrome), cardiovascular system (up to an acute heart failure and myocardial infarction), the gastro-intestinal tract, liver, kidneys and central nervous system (up to encephalitis and stroke). Therefore, peptide immunity modulator Thymalin, anticoagulant Heparin and anti-platelet agents are recommended to supplement conventional therapy in high-risk patients from the f rst day of their hospitalization in order to correct above disorders. The search of papers for this review has been made through PubMed in the English and Russian languages. The review includes papers published in the period of 2000—2020.

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