Toxicologist`s opinion on the mechanisms of virus-induced hemoglobinopathies with toxic pneumonitis and systemic hypoxemia from COVID-19 and substantiation of rational detoxification methods

Abstract

Coronavirus disease COVID-19 is currently a global problem for humanity, becoming a pandemic. From the standpoint of toxicologists, there is a need to summarize the literature on the pathogenetic and pathophysiological mechanisms of the main clinical manifestations about COVID-19 and to justify ways to optimize treatment strategies using detoxification therapy. Purpose. Based on the analysis of literature data to identify pathogenetic mechanisms of the main clinical COVID-19 syndromes, to summarize the results of clinical and laboratory studies, clinical and hematological criteria for predicting severe cases with fatalities and to justify ways to optimize detoxification therapy. Material and Methods. Analytical review of scientific publications was performed using abstract databases of scientific libraries PubMed, Medline and text databases of scientific publishers Elsevier, PubMed Central, BMJ Group and other VIP-databases and covers the period from January 1, 2020 to April 30, 2020. Methods of system, comparative and content analysis are used. Results and Conclusions. Publications on the identification of infection ways with SARS-CoV-19 virus, mechanisms in formation for clinical manifestations of COVID-19 different disease variants to identify the most informative predictors of the severe disease forms that lead to fatalities are analyzed. Literature data on the mechanisms of viremia development of SARS-CoV-19, pathogenetic and pathophysiological mechanisms of virus-induced hemoglobinopathies, toxic pneumonitis, systemic hypoxemia, hyperferritinemia, cytokine “storm”, oxidative stress and endotoxicosis are summarized; improvement of detoxification therapy which included efferent treatments, the complexing agents to remove excess levels of iron and ferritin, antioxidants and antihypoxants, oxygen therapy, transfusion of immune plasma convalescents, donor blood components and stem cells, was justified. Key Words: coronavirus disease, COVID-2019, virus-induced hemoglobinopathies, pneumonitis, detoxification therapy.