Abstract

Coronavirus infection disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was firstly reported in China, in December 2019, and in January 2020 was defined by the World Health Organization (WHO) as a public health emergency of international importance. COVID-19 outbreak quickly reached virtually all the countries in the world, leading the WHO to change it classification, defining the disease as a pandemic. Less than 2 years after the notification of the first COVID-19 patient, the world records more than 206 million of registered cases of the disease, 4,34 million of deaths caused by this pathology and the emergence of several SARSCoV- 2 variants.

The range of clinical presentations of COVID-19 is extremely wide and may vary from an asymptomatic condition to severe respiratory and multiple organ failure, which may lead to death [1,2]. The most common clinical symptoms include; dry cough, fatigue, loss of taste and smell, fever and dyspnea, which vary in intensity and may be moderate and comparable to the manifestations of a common cold, or severe, leading to the need for hospitalization and respiratory support due to acute lung injury. In addition to the classic respiratory syndrome symptoms, other clinical and laboratory features, such as changes in the activation of blood coagulation pathways, were observed in COVID-19 patients, who may present fibrin deposition and disseminated intravascular micro thrombosis affecting nervous central system (NCS), the urinary system, among other organs. The pathophysiological mechanisms that determine the severity of COVID-19 manifestations are still unclear, and may depend on genetic susceptibility, preexisting conditions; such as diabetes, hypertension and obesity, and individual general health. Main articles and case reports published to date, show the presence of at least two distinct phases in the evolution of COVID-19 pathology: The first, directly triggered by the viral infection, and the second, more severe and generally correlated with a worse prognosis for the patient, promoted by the exacerbated immune response of the host organism, a life-threatening systemic inflammatory syndrome known as “Cytokine Storm” [3, 4].