Pathophysiology-based mechanism and management strategies for deadly leaking lungs caused by 2019 novel coronavirus

Subjects: Medicine, Pharmacy >> Preclinical Medicine Subjects: Medicine, Pharmacy >> Other Disciplines of Medicine and Pharmacology submitted time 2020-02-25

Chen, Sifeng

Abstract： The 2019 novel coronavirus has killed 2596 globally since the outbreak began in December 2019 and more than 11,000 patients are still in severe conditions. The virus and medical conditions caused by the virus were named as SARS-CoV-2 and COVID-19. Although antiviral, symptomatic, and functionally supportive treatments have been applied, more than 100 patients die each day from infection with the virus. The most common deadly complication of COVID-19 is acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection may become pandemic. ARDS is caused by various similar viruses, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and influenza viruses. Thus, strategies for decreasing the mortality of virus-initiated ARDS are needed at the urgent, long-term, and broad levels. ARDS was previously referred to as wet lungs with vascular leaking, which described the clinical manifestations and chest computed tomography images of COVID-19-ARDS. Determining from where and how water is leaking into the lungs will lead to the development of mechanism-based management strategies for reducing mortality. These approaches can be used to prevent and stop water leakage from the pulmonary capillary into the lung interstitial space. For mild and moderate cases, nonsteroidal anti-inflammatory drugs, such as those used for rheumatoid arthritis, may be useful for preventing and deceasing this water leakage. Administration of immunosuppressants, such as sirolimus and tacrolimus, may stagger the peak times of injuries caused by viral infection, immune response, and non-immune inflammation to decrease the extent of water leakage and prevent life-threatening conditions. Using anti-flame (Qing-Huo) Chinese herbs may also be useful. For severe case, blood dialysis can be an effective strategy for eliminating most inflammatory mediators and cytotoxic substances.

Peer Review Status:Awaiting Review

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