Page 44 - Living-on-the-frontline-of-COVID-19-in-MCO-and-CMCO

Pathogenesis of lung damage

Diagram 7: Pathophysiology of SARS-CoV-2 induced lung injury. Link to the slide
presentation https://cutt.ly/NyCBn0B

I would like to bring you to the pathogenesis on how the lung damage occurred in a
patient who is infected by SARS-CoV-2 or COVID-19 patient. The SARS-CoV-2
induced lung injury. The SARS-CoV-2 is the virus that binds into the Angiotensin

Converting Enzyme 2 (ACE-2) receptor, which is mediated by the S-glycoprotein.
As it enters, it will go and concentrate at the respiratory tract because the ACE-2

receptors are highly expressed at the lower respiratory tract. There are a lot of
alterations in the alveolar- capillary micro environment. So all these processes as
mentioned earlier happened in the hyperinflammation phase. This is due to the

cytokine storm syndrome where all the pro-inflammatory cytokines are being
elevated. And it also caused a dysregulated release of proteolytic enzymes and also
unregulated the angiogenic responses. All these three will cause fibroproliferation

with the formation of a provisional extracellular matrix. And this process is also
seen in patients with idiopathic pulmonary fibrosis. So it's a disease that forms a
pulmonary fibrosis which is progressive. You could see this pathway actually lead