Advances in Current BiologyAdvances in Current BiologyУспехи современной биологии0042-13243034-6347The Russian Academy of Sciences69097510.31857/S0042132425030016hoamxyArticlesСтатьиResearch ArticlePathogenetic predictors of complications of the new coronavirus infection SARS-CoV-2Патогенетические предикторы осложнений новой коронавирусной инфекции SARS-COV-2ChepurS. V.ЧепурС. В.gniiivm_2@mil.ruPluzhnikovN. N.ПлужниковН. Н.gniiivm_2@mil.ruChubarO. V.ЧубарьО. В.gniiivm_2@mil.ruBakulinaL. S.БакулинаЛ. С.gniiivm_2@mil.ruLitvinenkoI. V.ЛитвиненкоИ. В.gniiivm_2@mil.ruTjuninM. A.ТюнинМ. А.gniiivm_2@mil.ruMjasnikovaI. A.МясниковаИ. А.gniiivm_2@mil.ruPugachV. A.ПугачВ. А.gniiivm_2@mil.ruState Scientific Research Testing Institute of Military MedicineГосударственный научно-исследовательский испытательный институт военной медицины Минобороны РоссииBurdenko Voronezh State Medical UniversityВоронежская государственная медицинская академия им. академика Н.Н. Бурденко Минздрава РоссииKirov Military Medical AcademyВоенно-медицинская академия им. С.М. Кирова Минобороны России150620251453VOL 145, NO3 (2025)ТОМ 145, №3 (2025)19321521092025Copyright ©; 2025, Russian Academy of SciencesCopyright ©; 2025, Российская академия наук2025Russian Academy of SciencesРоссийская академия наукhttps://journals.eco-vector.com/0042-1324/article/view/690975

The pathological processes contributing to local (at the site of invasion) and systemic (thrombotic and fibrotic manifestations) complications of the new coronavirus infection are assessed. The features of virus internalization into cells, S-protein-dependent biochemical processes that form inflammatory and barrier reactions are analyzed. When studying the options for evading the virus from the immune control systems, attention is paid to the uncoupling of phagocytosis from lytic processes compartmentalized in lysosomes during the penetration of SARS-CoV-2 into cells, as well as to the multilevel suppression of the interferon response. COVID-19 is a powerful stress factor and is associated with an increase in cortisol, catecholamines and lactate in the blood. Under hypoxic conditions, deviations in the course of metabolic processes and the reception of signaling molecules are traced. The redistribution of ionized iron in the progression of the viral process and the formation of its complications is traced. An important role in the formation of cellular damage and tissue structure reorganization is played by the systemic inflammatory response and immunothrombosis, associated with the formation of extracellular neutrophil traps, as a form of apoptotic cell death. The significance of DNA methylation, the appearance of mobile genetic elements and non-coding RNA is estimated. The formation of structural changes is largely associated with fibrosis, realized in particular through the virus-activated epithelial-mesenchymal transition, local and systemic correction of which will reduce the risk of complications of the infectious process.

Оценены патологические процессы, способствующие локальным (в месте инвазии) и системным (тромботические и фибротические проявления) осложнениям новой коронавирусной инфекции. Проанализированы особенности интернализации вируса в клетки, S-протеин-зависимые биохимические процессы, формирующие воспалительные и барьерные реакции. При исследовании вариантов уклонения вируса от систем иммунологического контроля обращено внимание на раз- общение фагоцитоза с литическими процессами, компартментализованными в лизосомах, при проникновении SARS-CoV-2 в клетки, а также на разноуровневое подавление интерферонового ответа. COVID-19 выступает мощным стрессогенным фактором, что сопряжено с нарастанием в крови кортизола, катехоламинов и лактата. В условиях гипоксии отмечены отклонения в протекании метаболических процессов и рецепции сигнальных молекул. Прослежено перераспределение ионизированного железа в прогрессии вирусного процесса и формировании его осложнений. Важную роль в формировании клеточных повреждений и перестроек структуры тканей играет системная воспалительная реакция и иммунотромбоз, сопряженный с формированием внеклеточных нейтрофильных ловушек, как формы апоптотической гибели клеток. Оценено значение метилирования ДНК, появления мобильных генетических элементов и некодирующих РНК. Формирование структурных изменений во многом сопряжено с фиброзированием, реализуемым, в частности, посредством активируемого вирусом эпителиально-мезенхимального перехода, локальная и системная коррекция которого снизит риск осложнений инфекционного процесса.

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