OBJECTIVE: In human pathology, SARS-CoV-2 utilizes multiple molecular pathways to determine structural and biochemical changes within the different organs and cell types. The clinical picture of patients with COVID-19 is characterized by a very large spectrum. The reason for this variability has not been clarified yet, causing the inability to make a prognosis on the evolution of the disease. MATERIALS AND METHODS: PubMed search was performed focusing on the role of ACE 2 receptors in allowing the viral entry into cells, the role of ACE 2 downregulation in triggering the tissue pathology or in accelerating previous disease states, the role of increased levels of Angiotensin II in determining endothelial dysfunction and the enhanced vascular permeability, the role of the dysregulation of the renin angiotensin system in COVID-19 and the role of cytokine storm. RESULTS: The pathological changes induced by SARS-CoV-2 infection in the different organs, the correlations between the single cell types targeted by the virus in the different human organs and the clinical consequences, COVID-19 chronic pathologies in liver fibrosis, cardiac fibrosis and atrial arrhythmias, glomerulosclerosis and pulmonary fibrosis, due to the systemic fibroblast activation induced by angiotensin II are discussed. CONCLUSIONS: The main pathways involved showed different pathological changes in multiple tissues and the different clinical presentations. Even if ACE2 is the main receptor of SARS-CoV-2 and the main entry point into cells for the virus, ACE2 expression does not always explain the observed marked inter-individual variability in clinical presentation and outcome, evidencing the complexity of this disorder. The proper interpretation of the growing data available might allow to better classifying COVID-19 in human pathology.
OBJECTIVE: In human pathology, SARS-CoV-2 utilizes multiple molecular pathways to determine structural and biochemical changes within the different organs and cell types. The clinical picture of patients with COVID-19 is characterized by a very large spectrum. The reason for this variability has not been clarified yet, causing the inability to make a prognosis on the evolution of the disease. MATERIALS AND METHODS: PubMed search was performed focusing on the role of ACE 2 receptors in allowing the viral entry into cells, the role of ACE 2 downregulation in triggering the tissue pathology or in accelerating previous disease states, the role of increased levels of Angiotensin II in determining endothelial dysfunction and the enhanced vascular permeability, the role of the dysregulation of the renin angiotensin system in COVID-19 and the role of cytokine storm. RESULTS: The pathological changes induced by SARS-CoV-2 infection in the different organs, the correlations between the single cell types targeted by the virus in the different human organs and the clinical consequences, COVID-19 chronic pathologies in liver fibrosis, cardiac fibrosis and atrial arrhythmias, glomerulosclerosis and pulmonary fibrosis, due to the systemic fibroblast activation induced by angiotensin II are discussed. CONCLUSIONS: The main pathways involved showed different pathological changes in multiple tissues and the different clinical presentations. Even if ACE2 is the main receptor of SARS-CoV-2 and the main entry point into cells for the virus, ACE2 expression does not always explain the observed marked inter-individual variability in clinical presentation and outcome, evidencing the complexity of this disorder. The proper interpretation of the growing data available might allow to better classifying COVID-19 in human pathology.
Authors: Jasjit S Suri; Sushant Agarwal; Gian Luca Chabert; Alessandro Carriero; Alessio Paschè; Pietro S C Danna; Luca Saba; Armin Mehmedović; Gavino Faa; Inder M Singh; Monika Turk; Paramjit S Chadha; Amer M Johri; Narendra N Khanna; Sophie Mavrogeni; John R Laird; Gyan Pareek; Martin Miner; David W Sobel; Antonella Balestrieri; Petros P Sfikakis; George Tsoulfas; Athanasios D Protogerou; Durga Prasanna Misra; Vikas Agarwal; George D Kitas; Jagjit S Teji; Mustafa Al-Maini; Surinder K Dhanjil; Andrew Nicolaides; Aditya Sharma; Vijay Rathore; Mostafa Fatemi; Azra Alizad; Pudukode R Krishnan; Ferenc Nagy; Zoltan Ruzsa; Mostafa M Fouda; Subbaram Naidu; Klaudija Viskovic; Mannudeep K Kalra Journal: Diagnostics (Basel) Date: 2022-06-16
Authors: Stefanos Drakos; Grigorios Chatzantonis; Michael Bietenbeck; Georg Evers; Arik Bernard Schulze; Michael Mohr; Helena Fonfara; Claudia Meier; Ali Yilmaz Journal: Sci Rep Date: 2021-08-02 Impact factor: 4.379