References

nbsprot

Вестник войск РХБ защиты

Journal of NBC Protection Corps

2587-57283034-2791

27 Научный центр

10.35825/2587-5728-2020-4-3-338-373

ltdlxr

nbsprot-120

Research Article

Биологическая безопасность и защита от биологических угроз

Biological Security and Protection against Biological Threats

Пандемия COVID-19 как индикатор «белых пятен» в эпидемиологии и инфекционной патологии

COVID-19 Pandemic as an Indicator of «Blank Spots» in Epidemiology and Infectious Pathology

Супотницкий

М. В.

Supotnitskiy

M. V.

Супотницкий Михаил Васильевич. Главный специалист, канд. биол. наук, ст. науч. сотр.

105005, г. Москва, Бригадирский переулок, д. 13

Mikhail Vasilyevich Supotnitskiy. Senior Researcher. Chief Specialist. Candidate of Biological Sciences.

Brigadirskii Lane 13, Moscow 105005

27nc_1@mil.ru

Федеральное государственное бюджетное учреждение «27 Научный центр» Министерства обороны Российской ФедерацииРоссияFederal State Budgetary Establishment «27 Scientific Centre» of the Ministry of Defence of the Russian FederationRussian Federation

2020

15062023

43338373

2023

Супотницкий М.В.

Supotnitskiy M.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nbsprot.ru/jour/article/view/120

Пандемия COVID-19 (Coronavirus Disease 2019) выявила множество «белых пятен» в эпидемиологической науке как раз тогда, когда у человечества появилась уверенность в том, что эпидемические катастрофы остались в далеком прошлом. Цель работы – рассмотреть пандемию COVID-19 как индикатор «белых пятен» в эпидемиологии и инфекционной патологии. В статье обосновывается, что эпидемия COVID-19 началась гораздо раньше, чем ее распознали в Китае. Неудачи установления первичного природного резервуара SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) среди позвоночных организмов предполагают расширение круга поисков на беспозвоночные организмы. Причинами глобального распространения SARS-CoV-2 могут быть наличие еще не установленных многочисленных первичных и вторичных природных очагов вируса среди животных в ближайшем окружении человека, высокая трансмиссивность вируса, а также его пресимптоматическая передача. Высокая трансмиссивность SARS-CoV-2 стала возможной благодаря: большей, чем у вирусов близкородственных видов, величине энергии связывания S1-белка вируса с его рецептором ACE2; более эффективному проникновению вируса в эндосомы клетки; работе репликационно-транскрипционного комплекса, противодействующего врожденному защитному ответу клетки. Пресимптоматическая передача SARS-CoV-2, ставшая ключевой в пандемическом распространении SARS-CoV-2 – следствие позднего обнаружения вируса врожденной иммунной системой. Заболевший человек сначала становится заразным для окружающих, а потом у него появляются симптомы болезни. Высказано предположение, что пандемия COVID-19 – не самостоятельное событие, вызванное появлением «нового вируса» (вроде очередной пандемии гриппа), а проявление более сложного и опасного явления – смены фазы многовекового глобального пандемического цикла, когда из-за роста плотности иммунодефицитных и ослабленных различной патологией популяций (хронические болезни, накопление генетических дефектов, старение и др.) и обострившихся социальных проблем на смену нециклическим пандемиям и циклическим малоконтагиозным эпидемиям приходят циклические, вызываемые высококонтагиозными патогенами. SARS-CoV-2 – не последний в этих событиях. К тяжелому клиническому течению COVID-19 приводят такие еще малоизученные процессы, как «разбалансировка» ренин-ангиотензин-альдостероновой системы, цитокиновый шторм, септическое течение болезни, генетические факторы пациента и развившаяся в ходе инфекционного процесса иммунопатология (антитело-зависимое усиление инфекции, антигенный импринтинг, антифосфолипидный синдром, наличие антиинтерфероновых антител и др. факторы). Заполнение этих «белых пятен» станет катализатором исследовательской революции в эпидемиологии и инфекционной патологии.

The COVID-19 (Coronavirus Disease 2019) pandemic revealed many «blank spots» in epidemiology at that very moment when humanity became confident that all epidemic disasters had remained in the distant past. The aim of this article is to study COVID-19 pandemic as an indicator of «blank spots» in epidemiology and infectious pathology. The article substantiates that the COVID-19 epidemic started much earlier than it was identified and recognized in China. The failure to establish the primary natural reservoir of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) among vertebrates suggests an expansion of searches for invertebrates. The reasons for the global spread of SARS-CoV-2 may be the presence of numerous unidentified primary and secondary natural foci of the virus among animals living close to humans, the high transmissibility of the virus and its presymptomatic transmission. High transmissibility of SARS-CoV-2 is possible because: the binding energy of S1 protein of the virus with its receptor ACE2 is higher than that of viruses of closely related species; the virus penetrates into the endosomes of the cells more efficiently; because of the work of the replication-transcription complex, which counteracts the innate protective response of cells. The presymptomatic transmission of SARSCoV-2, which has become the main reason for the pandemic spread of SARS-CoV-2, is a consequence of the late detection of the virus by the innate immune system. Infected individual becomes contagious first, and then the specific symptoms of the disease appear. It is suggested in the article, that the COVID-19 pandemic is not an independent event caused by the emergence of a «new virus» (like one more flu pandemic), but a manifestation of a more complex and dangerous phenomenon, i.e. a change of the phase of the centuries-old global pandemic cycle, when, due to the increase in the density of immunodeficient populations weakened by various pathologies (chronic diseases, accumulation of genetic defects, aging, etc.) and aggravated social problems, non-cyclic pandemics and cyclical low-contagious epidemics are replaced by cyclical ones caused by highly contagious pathogens. SARS-CoV-2 is not the last in these events. The severe clinical course of COVID-19 is caused by such poorly understood phenomena as «imbalance» of renin–angiotensin–aldosterone system, cytokine storm, septic course of the disease, the patient`s genetic factors and immunopathology, developed during the infectious process (antibodydependent enhancement enhancement of infection, antigenic imprinting, antiphospholipid syndrome and other factors). Filling these «blank spots» will catalyze a research revolution in epidemiology and infectious pathology.

атипичная пневмониякоронавирусмежвидовая передачапатогенезпресимптоматическая передачаренин-ангиотензин-альдостероновая системасепсисCOVID-19SARS-CoV-2

Atypical pneumoniacoronavirusinterspecies transmissionpathogenesispresymptomatic transmissionrennin-angiotensin-aldosterone systemRAASsepsisCOVID-19SARS-CoV-2

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The authors declare that there are no conflicts of interest present.