Morphofunctional changes in the conducting and respiratory parts of the bronchopulmonary system in COVID-19 (analytical review)

Abstract

The article reflects the analysis of the state of the problem concerning the pathogenesis of COVID-19 (CoronaVirus Disease 2019), the epidemic of which began from the end of 2019 to the beginning of 2020, from the position of the bronchopulmonary system, which is associated with the main route of penetration of the virus of this infectious disease (SARS-CoV-1) with the development of severe pneumonia, often fatal. And if the study and results of the study of this problem are to a certain extent highlighted in the literature, then they concerned mainly the respiratory regions of the respiratory tract (RT), given that mainly complications leading to death are associated with them. At the same time, studies on conducting RT are reflected in a few foreign works, although there are data suggesting their not small contribution to the pathogenesis of COVID-19. In the domestic literature, studies of this kind have not been reflected.

The aim of the work is to analyze, reflect and assess the role of possible morphological and functional regional changes in the mucous membrane of the RT in the pathogenesis of COVID-19.

Methodologically, the analysis was carried out using a systematic approach based on the material of various databases of biomedical and biomedical scientific information, including such as Index Medicus, PubMed, EMBASE, Cochrane, and others for the period, mainly 2020.

Results. An analysis of the mechanisms of influence on the morphofunctional state of the mucous membrane of the RT of coronavirus infection is given, depending on their departments, including conductive and respiratory. Methods and approaches to the study of such influence are reflected. The possible role of disturbances in the morphofunctional state and defense mechanisms of the lungs is shown, hypotheses and paradigms regarding the pathogenesis of coronavirus infection are presented.

The results of the analysis indicate that there is a whole complex of morphological and functional disorders that determine the development of this pathology, its virulence. The fundamental role of the epithelium of the respiratory tract has been established and multicellular receptor tropism in the pathogenesis of COVID-19 is reflected.

In conclusion, it is pointed out that the essential role of epithelial cells not only of the respiratory, but also of the conductive parts of the LTP, mainly ciliates, which are involved in the pathogenesis of COVID-19 not only from the position of functional receptors, but also in terms of violations of the earliest leading protective mechanism - mucociliary clearance aggravating the "vicious circle of pathogenesis" of this pathology.

Keywords:morphology, mucociliary and alveolar clearance, mechanisms of COVID-19 pathogenesis

Funding. The work was done without sponsorship.

Conflict of interest. The author declares no conflicts of interest.

For citation: Kobylyansky V.I. Morphofunctional changes in the conducting and respiratory parts of the bronchopulmonary system in COVID-19 (analytical review). Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2021; 10 (2): 69-77. DOI: https://doi.org/10.33029/2305-3496-2021-10-2-69-77 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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