Effects of COVID-19 on Homeostatic Balance

Abstract

Coronavirus disease 2019 (Covid-19) has become a global epidemic affecting millions of people around the world. It has been declared a pandemic by the World Health Organization as of March 2020. The symptoms of Covid-19 were variable, and even though the course was not the same in all patients, it often resulted in asymptomatic infection, acute lung injury, severe respiratory distress syndrome (ARDS), and death. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses ACE-2 receptors to enter the cell, similar to SARS-CoV. ACE-2 is wide in the lung and small intestinal epithelium of humans. This clearly makes respiratory and gastrointestinal system elements the target tissue. The ample expression of ACE-2 on the surface of bronchial epithelial cells results in local inflammation, coagulation, and leakage from capillaries in case of infection. Disrupted endothelial structure initiates unregulated cytokine release. It is clear that the overproduction and release of pro-inflammatory
cytokines is the crux of the cytokine storm. In thissituation; The need for mechanical ventilation can lead to sepsis, septic shock, acute respiratory distress syndrome (ARDS), and multiple organ dysfunction syndromes. Alterations in the intestinal microbiota may induce negative effects on the brain and lung tissues through various mechanisms. Abnormal levels of liver enzymes have been noted in patients infected with SARS-CoV-2. Most liver damage is mild and temporary, but serious liver damage can also happen. People with severe diseases have a higher rate of liver damage. Covid-19 leads to the deterioration of iron metabolism in patients. Common findings of patients with anemia include advanced age, impaired renal function, and elevated inflammation markers. Apart from these, monitoring different hematological, immunological, and biochemical markers can give us information about the disease.