ERS |monograph
Preface
Anh Tuan Dinh-Xuan
Even though SARS-CoV-2 can theoretically infect a variety of
organs after binding to the ubiquitous ACE2 cell membrane
receptor, the respiratory system is still the most frequently
impacted due to the airborne nature of the infective agent. The
clinical picture is very heterogeneous, but the potential for
severe life-threatening conditions in adults comes from lung
injury, as inflammatory processes causing airways, alveolar and
vascular dysfunction and damage can lead to rapidly progressive
acute hypoxaemic respiratory failure. Since its appearance in
December 2019, it has become rapidly apparent that this new
disease behaves very differently from previously known viral
pneumonias in terms of risk factors and clinical, radiological
and biological presentations. It has challenged, and continues to
challenge, our knowledge whilst also urging in-depth basic
research and rapidly evolving clinical guidance, both of which
are mandatory to improve patient care and support public
health decisions.
Adaptive mutations of the SARS-CoV-2 genome alter its
pathogenic potential, which in turn increases the already
significant obstacles to drug and vaccine development. As with
other RNA viruses, the rate of nucleotide substitution in the
SARS-CoV-2 genome is fast, and this rapid evolution is mainly
shaped by natural selection. Despite the extraordinary speed of
vaccine development against COVID-19 and 8 billion vaccine
doses administered to date, the very recent emergence of
omicron, yet another variant of concern which threatens to
supersede the already dreadful delta variant, highlights the
ongoing difficulties of achieving global control of the pandemic.
Nevertheless, at the time of writing in December 2021, 2 years
after the pandemic outbreak, we can state that much has been
learned about the pathogenesis, epidemiology and clinical
management of COVID-19. No other medical condition has
ever had such a “high speed” dynamic in the emergence of
medical knowledge, as reflected by the unprecedented
exponential rise in scientific publications over the past 2 years.
Copyright ©ERS 2021. Print ISBN: 978-1-84984-148-1. Online ISBN: 978-1-84984-149-8. Print ISSN: 2312-508X. Online ISSN: 2312-5098.
https://doi.org/10.1183/2312508X.10021321 v
Preface
Anh Tuan Dinh-Xuan
Even though SARS-CoV-2 can theoretically infect a variety of
organs after binding to the ubiquitous ACE2 cell membrane
receptor, the respiratory system is still the most frequently
impacted due to the airborne nature of the infective agent. The
clinical picture is very heterogeneous, but the potential for
severe life-threatening conditions in adults comes from lung
injury, as inflammatory processes causing airways, alveolar and
vascular dysfunction and damage can lead to rapidly progressive
acute hypoxaemic respiratory failure. Since its appearance in
December 2019, it has become rapidly apparent that this new
disease behaves very differently from previously known viral
pneumonias in terms of risk factors and clinical, radiological
and biological presentations. It has challenged, and continues to
challenge, our knowledge whilst also urging in-depth basic
research and rapidly evolving clinical guidance, both of which
are mandatory to improve patient care and support public
health decisions.
Adaptive mutations of the SARS-CoV-2 genome alter its
pathogenic potential, which in turn increases the already
significant obstacles to drug and vaccine development. As with
other RNA viruses, the rate of nucleotide substitution in the
SARS-CoV-2 genome is fast, and this rapid evolution is mainly
shaped by natural selection. Despite the extraordinary speed of
vaccine development against COVID-19 and 8 billion vaccine
doses administered to date, the very recent emergence of
omicron, yet another variant of concern which threatens to
supersede the already dreadful delta variant, highlights the
ongoing difficulties of achieving global control of the pandemic.
Nevertheless, at the time of writing in December 2021, 2 years
after the pandemic outbreak, we can state that much has been
learned about the pathogenesis, epidemiology and clinical
management of COVID-19. No other medical condition has
ever had such a “high speed” dynamic in the emergence of
medical knowledge, as reflected by the unprecedented
exponential rise in scientific publications over the past 2 years.
Copyright ©ERS 2021. Print ISBN: 978-1-84984-148-1. Online ISBN: 978-1-84984-149-8. Print ISSN: 2312-508X. Online ISSN: 2312-5098.
https://doi.org/10.1183/2312508X.10021321 v