Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression

Mary Kathryn Bohn; Alexandra Hall; Lusia Sepiashvili; Benjamin Jung; Shannon Steele; Khosrow Adeli

doi:10.1152/physiol.00019.2020

Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression

Physiology (Bethesda). 2020 Sep 1;35(5):288-301. doi: 10.1152/physiol.00019.2020.

Authors

Mary Kathryn Bohn^{1

2}, Alexandra Hall¹, Lusia Sepiashvili^{1

2}, Benjamin Jung^{1

2}, Shannon Steele¹, Khosrow Adeli^{1

2

3}

Affiliations

¹ Molecular Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
² Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
³ Department of Physiology, University of Toronto, Toronto, Ontario, Canada.

Abstract

The global epidemiology of coronavirus disease 2019 (COVID-19) suggests a wide spectrum of clinical severity, ranging from asymptomatic to fatal. Although the clinical and laboratory characteristics of COVID-19 patients have been well characterized, the pathophysiological mechanisms underlying disease severity and progression remain unclear. This review highlights key mechanisms that have been proposed to contribute to COVID-19 progression from viral entry to multisystem organ failure, as well as the central role of the immune response in successful viral clearance or progression to death.

Keywords: COVID-19; coagulation; cytokine storm; multisystem organ failure; pathophysiolog.

Publication types

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

MeSH terms

Betacoronavirus / pathogenicity*
COVID-19
Coronavirus Infections / physiopathology*
Coronavirus Infections / virology*
Cytokines / metabolism
Disease Progression
Humans
Pandemics
Pneumonia, Viral / physiopathology*
Pneumonia, Viral / virology*
SARS-CoV-2

Substances

Cytokines