SARS-CoV-2 and viral sepsis: observations and hypotheses. Issue 10235 (9th May 2020)

• Record Type: Journal Article
• Authors: Li, Hui; Liu, Liang; Zhang, Dingyu; Xu, Jiuyang; Dai, Huaping; Tang, Nan; Su, Xiao; Cao, Bin
• Is Part Of: Lancet. Volume 395:Issue 10235(2020)
• Page Start: 1517
• Page End: 1520
• Publication Date: 2020-05-09
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(20)30920-X
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have tried every effort to understand the disease, and a brief portrait of its clinical features have been identified. In clinical practice, we noticed that many severe or critically ill COVID-19 patients developed typical clinical manifestations of shock, including cold extremities and weak peripheral pulses, even in the absence of overt hypotension. Understanding the mechanism of viral sepsis in COVID-19 is warranted for exploring better clinical care for these patients. With evidence collected from autopsy studies on COVID-19 and basic science research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV, we have put forward several hypotheses about SARS-CoV-2 pathogenesis after multiple rounds of discussion among basic science researchers, pathologists, and clinicians working on COVID-19. We hypothesise that a process called viral sepsis is crucial to the disease mechanism of COVID-19. Although these ideas might be proven imperfect or even wrong later, we believe they can provide inputs and guide directions for basic research at this moment.