nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2021-25-2-18-26nefr-1939Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПатогенез внелегочного поражения органов при инфицировании коронавирусом SARS-CоV-2 (аналитический обзор)Pathogenesis of extrapulmonary organ damage in SARS-CоV-2 coronavirus infection (analytical review)https://orcid.org/0000-0001-5251-145XЛитвиновА. С.LitvinovA. S.

Литвинов Александр Сергеевич, канд. мед. наук; ведущий научный специалист; заместитель генерального директора по медицинской части

450000, г. Уфа, ул. Карла Маркса, д. 48/2

Тел.: +7(347)246-38-16

 г. Лондон

Alexander S. Litvinov, MD, PhD; Leading Scientifi c Specialist, researcher; Deputy Medical Director

450000, Russia, Ufa, st. Karl Marx, 48/2

(812)346-39-26

London, United Kingdom

 

dirge@yandex.ruhttps://orcid.org/0000-0003-2705-1038СавинА. В.SavinA. V.

Савин Альберт Владимирович, врач-нефролог, ведущий специалист

344022, Россия, г. Ростов-на-Дону, ул. Красноармейская, д. 170

Аlbert V. Savin, nephrologist; Leading Scientifi c Specialist, researcher

344022, Russia, Rostov-on-Don, 170 Krasnoarmeyskaya st.

 

https://orcid.org/0000-0001-5963-6634КухтинаА. А.KukhtinaA. A.

Кухтина Алина Алексеевна, врач-ординатор

127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1

Тел.: 8(903)624-77-28

Alina A. Kukhtina, resident

127473, Russia, Moscow, 20/1 Delegatskaya st.

8(903)624-77-28

dr.alina.a@mail.ruСитовскаяД. А.SitovskayaD. A.

Ситовская Дарья Александровна, научно-исследовательская лаборатории патоморфологии нервной системы, научн. сотр.

191014, Россия, Санкт-Петербург, ул. Маяковского, д. 12

Daria A. Sitovskaya, researcher; Leading Scientific Specialist

191014, Russia, St. Petersburg, 12 Mayakovskogo st.

Общество с ограниченной ответственностью «Медицинский центр “Агидель”»; Партнерство с ограниченной ответственностью «Metaco LLP»РоссияLimited liability Company "Agidel Medical center";Limited liability Partnership "Metaco LLP"Russian FederationОбщество с ограниченной ответственностью «ЮгЭкоСервис»; Ограниченное партнерство «Медицинская клиника “Гармония”»РоссияYugEkoService Limited liability Company; Limited Partnership "Harmony Medical Clinic"Russian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияMoscow state medical and dental University named after A. I. EvdokimovRussian FederationРоссийский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова (филиал Национального медицинского исследовательского центра им. В.А. Алмазова); Городская Мариинская больница; Санкт-Петербургский государственный педиатрический медицинский университетРоссияRussian Research Neurosurgical Institute professor A.L. Polenov (a branch of the National Medical Research Center named V.A. Almazov); City Mariinsky Hospital; St. Petersburg State Pediatric Medical UniversityRussian Federation2021120220212521826Copyright © Литвинов А.С., Савин А.В., Кухтина А.А., Ситовская Д.А., 20212021Литвинов А.С., Савин А.В., Кухтина А.А., Ситовская Д.А.Litvinov A.S., Savin A.V., Kukhtina A.A., Sitovskaya D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1939

За последние два десятилетия коронавирусная инфекция вызвала две масштабные пандемии: атипичную пневмонию (SARS) в 2002 г. и острый респираторный синдром (MERS) на Ближнем Востоке в 2012 г. В декабре 2019 года новый коронавирус (КВ) SARS-CoV-2 вызвал вспышку пневмонии в г. Ухань, Китай. Специалисты Всемирной организации здравоохранения (ВОЗ) подтвердили риск данного заболевания для общественного здоровья всей планеты. SARS-CoV-2 был выделен из эпителиальных клеток дыхательных путей человека. Было обнаружено, что генотип КВ SARS-CoV-2 ближе к bat-SL-CoVZC45 и bat-SL-CoVZXC21, а спайковый гликопротеин (СБ) вируса, определяющий возможность связывания с клеточным рецептором, подобен коронавирусу SARS-CoV, ответственному за вспышку тяжелого острого респираторного синдрома (ТОРС/SARS) в 2002 г.]. Ангиотензин-превращающий фермент 2 (АПФ2) является эндогенным спайковым белком (спайковый гликопротеин с S-доменом) SARS-CoV-2, который в составе комплекса АПФ2+SARS-CoV-2 связывается с рецептором АПФ2, находящимся на мембране клетки-мишени. В статье рассматриваются механизмы заражения SARS-CoV-2, межклеточные взаимодействия и пути передачи инфекции. Подробно освещены вопросы эпидемиологии COVID-19 и перспективы вовлечения других органов и систем, кроме дыхательной, в поддержание вирусной нагрузки. Выявлены проблемы иммунной защиты организма человека при инфицировании SARS-CoV-2. Проведены клинические параллели с вирусами-предшественниками, а именно SARS-CoV-1 и MERS-CoV. Выделены факторы риска инфицированности SARS-CoV-2, позволяющие прогнозировать характер течения и вероятные исходы COVID-19.

Over the past two decades, coronavirus infection has caused two major pandemics: SARS in 2002 and acute respiratory syndrome (MERS) in the Middle East in 2012. In December 2019, the novel coronavirus (CV) SARS-CoV-2 caused an outbreak of pneumonia in Wuhan, China. Experts from the World Health Organization (WHO) have confirmed the risk of this disease for the public health of the entire planet. SARS-CoV-2 was isolated from epithelial cells of the human respiratory tract. It was found that the genotype KB SARS-CoV-2 is closer to bat-SL-CoVZC45 and bat-SL-CoVZXC21, and the spike glycoprotein (SB) of the virus, which determines the ability to bind to the cellular receptor, is similar to the SARS-CoV coronavirus, which is responsible for the outbreak of severe acute respiratory syndrome (SARS / SARS) in 2002]. Angiotensin-converting enzyme 2 (ACE2) is an endogenous spike protein (spike glycoprotein with the S-domain) SARS-CoV-2, which, as part of the ACE2 + SARS-CoV-2 complex, binds to the ACE2 receptor located on the target cell membrane. The article discusses the mechanisms of infection with SARS-CoV-2, cell-cell interactions, and transmission routes. The issues of the epidemiology of COVID-19 and the prospects for the involvement of organs and systems other than the respiratory one in maintaining the viral load are covered in detail. The problems of the immune defense of the human body during infection with SARS-CoV-2 have been identified. Clinical parallels with progenitor viruses, namely SARS-CoV-1 and MERS-CoV, have been drawn. Highlighted risk factors for SARSCoV-2 infection, which make it possible to predict the nature of the course and probable outcomes of COVID-19.

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The authors declare that there are no conflicts of interest present.