Background Gaining further insights into SARS-CoV-2 routes of infection and the underlying pathobiology of COVID-19 will support the design of rational treatments targeting the life cycle of the virus and/or the adverse effects (e.g., multi-organ collapse) that are triggered by COVID-19-mediated adult respiratory distress syndrome (ARDS) and/or other pathologies. Main body COVID-19 is a two-phase disease being marked by ( phase 1 ) increased virus transmission and infection rates due to the wide expression of the main infection-related ACE2 , TMPRSS2 and CTSB/L human genes in tissues of the respiratory and gastrointestinal tract, as well as by ( phase 2 ) host- and probably sex- and/or age-specific uncontrolled inflammatory immune responses which drive hyper-cytokinemia, aggressive inflammation and (due to broad organotropism of SARS-CoV-2) collateral tissue damage and systemic failure likely because of imbalanced ACE/ANGII/AT1R and ACE2/ANG(1–7)/MASR axes signaling. Conclusion Here we discuss SARS-CoV-2 life cycle and a number of approaches aiming to suppress viral infection rates or propagation; increase virus antigen presentation in order to activate a robust and durable adaptive immune response from the host, and/or mitigate the ARDS-related “cytokine storm” and collateral tissue damage that triggers the severe life-threatening complications of COVID-19.
【저자키워드】 ACE2, ARDS, TMPRSS2, 【초록키워드】 COVID-19, Treatment, SARS-CoV-2, Inflammation, Respiratory distress syndrome, viral infection, ARDS, Cytokine storm, Phase 2, Infection, Sex, virus transmission, virus, adverse effects, Viral, immune responses, infection rate, Adaptive immune response, respiratory, Pathologies, expression, gastrointestinal tract, Signaling, distress, Propagation, Trigger, triggers, Phase 1, respiratory distress, life cycle, Support, adverse effect, AT1R, tissue, tissue damage, tissues, approaches, collateral tissue damage, CTSB, hyper-cytokinemia, infection rates, multi-organ collapse, respiratory and gastrointestinal tract, SARS-CoV-2 life cycle, systemic failure, two-phase disease, virus antigen presentation, syndrome, life-threatening, complications of COVID-19, human gene, inflammatory immune response, Host, mitigate, approach, robust, triggered, activate, suppress, “cytokine storm”, organotropism of SARS-CoV-2, pathobiology of COVID-19, 【제목키워드】 COVID-19, Treatment, pathophysiology, insight, clinical complication,