COVID Pathophysiology

Background and COVID-19 pathophysiology (April 2020)

  • Terminal respiratory issue = development of ARDS = inflammation, cytokine release, neutrophils and T-cells rushing in; lots of oxidative stress. (Siddiqi et al)

  • ARDS thought to be precipitated by overactive immune system and cytokine storm triggered by Reactive Oxygen Species (ROS) that signal inflammatory cells and cytokines

Stages of illness and timing of therapies proposed by Siddiqi HK and Mehra MR. COVID-19 Illness in Native and Immunosuppressed States: A Clinical-Therapeutic Staging Proposal. Journal of Heart and Lung Transplantation. March 25, 2020 online. doi:10.1016/j.healun.2020.03.012. [NAC administration during Stage II/Stage III AFTER pt has shown ability to mount an immune response added by M. Lai-Becker MD].