COVID-19 – A Complex Multi-system and Coagulation Disease

Abstract

Coronavirus disease 2019 (COVID-19) is a complex multisystem and coagulopathic disease that emerged in late 2019 and is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has since led to a global pandemic. COVID-19 is a disease the likes of which has not been seen before. It bears some similarity to severe acute respiratory syndrome (SARS) and Middle-East respiratory syndrome (MERS), but due to the global nature of the disease and the numbers of people affected by it, it has allowed medical researchers all around the world to begin to undertake a more comprehensive analysis of the disease. COVID-19 needs to be recognised as multisystem disease with associated derangement of the renin-angiotensin system, angiotensin converting enzyme 2 (ACE2) expressing cell loss, a subsequent relative angiotensin-converting enzyme 2 deficiency with imbalance towards ACE, and abnormal coagulation. This paper aims to examine this pathophysiology in more detail and how this will affect the role of hospital care and the role of general practitioners in the fight against this disease. It aims to challenge our clinical reasoning based upon the emerging pathophysiology of the disease and to encourage clinicians to continuously update their management of the disease based upon the evolving understanding of it.

Note: Funding: None to report.

Conflict of Interest: No conflicts of interest to report.