Coronavirus infection COVID-19. Scientific challenges and possible ways to treat and prevent the disease

The COVID-19 pandemic has exposed pain points of decentralized healthcare systems in the global world and a failure in scientific systems analysis of old and new infections. Eighteen years ago severe acute respiratory syndrome (SARS) was underestimated and etiopathogenetic research conducted around the world was not used to develop effective treatments and prevention of the disease. Moreover, the anti-epidemic tactics in the recommendations of the World Health Organization and national health systems in the fight against the pandemic were inconsistent and relied on the historical experience of the influenza pandemic and other epidemics of respiratory infections with an emphasis on the study of the biology of the pathogen and the adaptation of society to establish biological and social balance with it.

The study of the SARS-CoV-2 virus (severe acute respiratory syndrome-related coronavirus 2) from the point of view of its origin, genome, mutated strains, damaging factors in cell culture in vitro and autopsies in experimental animals and humans in foci of infection in no way answers the question of the reasons for the various responses of the host, including asymptomatic carriage with/without the formation of an immune response; definition of syndromic complexes and their periodization; options for the uncomplicated and complicated course of the disease; outcomes, including recovery with/without the formation of specific immunity and thanatogenesis, with the search for evidence of direct or indirect involvement of SARS-CoV-2 virus in adverse outcomes.

The underestimation of the host's responses to the effects of beta-coronavirus has led to syndromic polypharmacy using more than 30 drugs with anti-inflammatory, antiviral, antibacterial, anticoagulant, immunosuppressive, and other effects, including passive immunotherapy with plasma of recovered patients or therapeutic exchange plasmapheresis. Seven months of the fight against COVID-19 led, as one would expect, to the proven effect of only tough anti-epidemic measures, personal protective measures and hygiene in the absence of effective treatment and prevention measures. In fact, an empirical selection of national and international treatment protocols with a combination of non-specific syndromic drugs is underway in the world.

The critical review discusses scientific data and hypotheses of the origin of a new coronavirus infection, human ontogenetic response to infection with SARS-CoV-2, and emerging bioinformatic concepts of the pathogenesis of the disease and approaches to pathogenetic treatment.

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