Features of pathogenesis and COVID-19 course for the elderly and old age.

The causative agents of coronavirus infection have long been considered the cause of benign respiratory diseases «common colds» until their pathogenic types appeared on the epidemic arena: SARS-CoV-1, MERS and finally, SARS-CoV-2. Diseases caused by the listed viruses characterized by moderate invasiveness and noticeable mortality compared to other respiratory viruses. The pathogenesis of these infections is based on a wide range of innate immunity dysfunctions, manifested in the direct suppression of anti-inflammatory functions and, on the contrary, the activation of pro-inflammatory functions, such as the assembly and activation of NLRP3 inflammasome, as well as the synthesis and secretion of pro-inflammatory cytokines and chemokines. Excessive secretion of pro-inflammatory factors is accompanied by a disturbance in the balance of cytokines, leading to the development of a cytokine storm. When the body manages to cope with these disorders, a stable adaptive immunity develops, which is a harmonious combination of cellular and humoral mechanisms of resistance. Particularly difficult COVID-19 occurs in elderly and senile people. It has been shown that the main tests for the risk of multiple organ failure and death in COVID-19 in this category of patients are concomitant diseases, lymphocytopenia, increased transferases, D-dimer and other metabolic disorders. It has been established that critically ill COVID-19 patients develop endothelial dysfunction, thrombotic microangiopathy, immunothrombosis and disseminated intravascular coagulation, which are the basis of multiple organ failure. Pneumonia, as a complication of COVID-19, accompanied by the development of acute respiratory respiratory syndrome, ultimately leads to pulmonary fibrosis, which is often fatal. There is no specific therapy for COVID-19. Recently, immunomodulatory drugs have been widely introduced in the treatment of this infection, including remdesivir, synthetic quinine derivatives and neutralize antibodies.

Medienart:	Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:33
Enthalten in:	Advances in gerontology = Uspekhi gerontologii - 33(2020), 6 vom: 30., Seite 1032-1042

Sprache:	Russisch

Beteiligte Personen:	Kuznik, B I [VerfasserIn] Khavinson, V K [VerfasserIn] Smirnov, V S [VerfasserIn]

Themen:	Coronavirus infection Cytokines Elderly patients Hemostasis Immune response Journal Article Therapy

Anmerkungen:	Date Completed 30.03.2021 Date Revised 30.03.2021 published: Print Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM323308325