Activation of immuno-inflammatory response in patients with coronavirus disease (literature review)

The COVID-19 pandemic caused by the SARS-CoV-2 virus has become a global challenge. Community-acquired pneumonia associated with COVID-19 is still one of the most challenging medical problems. It is especially important to study the pathogenesis of Community-Acquired Pneumonia (CAP) and its relationship with various inflammatory processes that occur in the setting of coronavirus infection. The aim of this study was to analyze the pathogenesis of CAP that develops against the background of COVID-19, to study the mechanisms of immune response, inflammatory processes and their impact on the patient's body, and to identify possible approaches to the diagnosis and treatment of this disease. The following materials and research methods were used in the study: a review of scientific sources on the pathogenesis of CAP in COVID-19, the peculiarities of the immune response, cytokine storm and endothelial dysfunction in this pathology. The authors of the analyzed studies, in turn, used an analysis of inflammatory markers (C-reactive protein, D-dimer, cytokines). They report that patients with CAP developing against COVID-19 have activation of the neutrophil chain and a significant increase in the level of proinflammatory cytokines such as IL-6, IL-1β, TNF-α. These processes lead to the development of a severe inflammatory reaction in the lungs and diffuse alveolar damage, which in turn leads to the development of acute respiratory failure. It has been noted that excessive D-dimer release is a key indicator of the development of these complications. Prediction of severe forms of the disease based on the level of cytokines and other inflammatory markers can be an important tool for early detection of the risk of complications in patients. Thus, it was found that in order to improve the prognosis of patients, it is necessary to use methods of monitoring the level of inflammatory markers and individualise therapeutic strategies to correct immune system disorders.