Immune status and cytokine spectrum as predictive signs of the severity of the disease and the effectiveness of intensive care in patients with coronavirus infection COVID-19

The pandemic caused by a new strain of SARS-CоV-2 coronavirus has swept the whole world, however, despite the developed strategic directions for the treatment of coronavirus infection and intensive research in all countries, effective methods for treating this severe pathology have not yet been created. The list of drugs against COVID-19 practically does not use compounds that affect the renin-angiotensin system, in the functioning of which the ACE2 coronavirus binding receptor plays a central role. It is assumed that the virus, causing a decrease in the density of ACE2 receptors, leads to disruption of RAS activity. This review presents current research on the response of the immune system to infection with the SARS-CoV-2 virus, describes adaptive and innate cellular mechanisms, and describes a number of predictors of severe COVID-19. To write this review, a search was made in the PubMed database and the scientific electronic library eLibrary.ru. The selection of articles was carried out manually with the main goal of synthesizing data and describing the mechanisms of influence of SARS-CoV-2 on the renin-angiotensin system, and, as a result, on the activation of the adaptive and innate immune response. This review includes 53 publications, including methodological recommendations of the Ministry of Health of the Russian Federation, data from ongoing clinical trials and patents. Data from selected scientific sources were structured and visualized.