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COVID-19 is not a viral pneumonia — it is a viral vascular endotheliitis:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30937-5/fulltext

https://academic.oup.com/eurheartj/article/41/32/3038/5901158

https://www.embopress.org/doi/full/10.15252/embr.202152744

COVID-19 is not just a respiratory disease — it can precipitate multiple organ failure, including hypoxic and inflammatory damage to various vital organs, such as the brain, heart, liver, pancreas, kidneys, and intestines:

https://www.nature.com/articles/d41586-021-01693-6

https://www.health.harvard.edu/blog/the-hidden-long-term-cognitive-effects-of-covid-2020100821133

https://www.nature.com/articles/s41422-020-0390-x

https://www.embopress.org/doi/full/10.15252/embj.2020106230

https://jamanetwork.com/journals/jama/fullarticle/2776538

https://pubmed.ncbi.nlm.nih.gov/32921216/

https://www.nature.com/articles/s41575-021-00426-4

https://pubmed.ncbi.nlm.nih.gov/32553666/

https://www.nature.com/articles/s41467-021-23886-3

https://pubmed.ncbi.nlm.nih.gov/34081912/

https://www.nature.com/articles/s41581-021-00452-0

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438210/

https://www.nature.com/articles/s41598-021-92740-9

Some of the most common laboratory findings in COVID-19:

https://www.uptodate.com/contents/covid-19-clinical-features

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426219/

COVID-19 can present as almost anything:

https://www.nature.com/articles/s41591-020-0968-3

https://www.frontiersin.org/articles/10.3389/fmed.2020.00526/full

COVID-19 is more severe in those with conditions that involve endothelial dysfunction, such as obesity, hypertension, and diabetes:

https://www.dovepress.com/obesity-related-inflammation-and-endothelial-dysfunction-in-covid-19-i-peer-reviewed-fulltext-article-JIR

https://jamanetwork.com/journals/jama/fullarticle/2772071

https://mdpi-res.com/d_attachment/cells/cells-10-00933/article_deploy/cells-10-00933.pdf

The vast majority of COVID-19 cases are mild and do not cause significant disease:

https://www.webmd.com/lung/covid-recovery-overview#1

https://academic.oup.com/ofid/article/7/9/ofaa286/5875595

https://pubmed.ncbi.nlm.nih.gov/33289900/

In those who have critical COVID-19-induced sepsis, hypoxia, coagulopathy, and ARDS, the most common treatments are intubation, injected corticosteroids, and blood thinners like heparin, which often precipitate harmful hemorrhages:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548860/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448713/

https://www.nejm.org/doi/full/10.1056/NEJMoa2103417

The majority of people who go on a ventilator are dying due to COVID-19 mimicking the physiology of ischemia-reperfusion injury with prolonged transient hypoxia and ischemia, leading directly to the formation of damaging reactive oxygen species:

https://www.journalofsurgicalresearch.com/article/S0022-4804(14)00176-0/fulltext

https://www.nature.com/articles/nature13909

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625011/

https://www.atsjournals.org/doi/full/10.1164/rccm.201401-0168CP

https://pubmed.ncbi.nlm.nih.gov/18974366/

The end-stage of COVID-19 is severe lipid peroxidation, where fats in the body start to “rust” due to damage by oxidative stress:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768996/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357498/

https://www.liebertpub.com/doi/10.1089/ars.2021.0017

Oxidized lipids appear as foreign objects to the immune system, which recognizes and forms antibodies against OSEs, or oxidation-specific epitopes:

https://ard.bmj.com/content/annrheumdis/early/2020/08/04/annrheumdis-2020-218145.full.pdf

https://ard.bmj.com/content/80/9/1236

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256550/
https://www.hss.edu/conditions_top-ten-series-antiphospholipid-syndrome-coronavirus-covid-19.asp

In COVID-19, neutrophil degranulation and NETosis in the bloodstream drives severe oxidative damage; hemoglobin becomes incapable of carrying oxygen due to heme iron being stripped out of heme by hypochlorous acid:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757048/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436665/

https://www.nature.com/articles/s41418-021-00805-z

https://www.sciencedirect.com/science/article/pii/S221249262030052X

SARS-CoV-2 Spike binds to ACE2. Angiotensin Converting Enzyme 2 is an enzyme that is part of the renin-angiotensin-aldosterone system, or RAAS. The RAAS is a hormone control system that moderates fluid volume and blood pressure in the body and in the bloodstream by controlling sodium/potassium retention and excretion and vascular tone:

https://www.ncbi.nlm.nih.gov/books/NBK470410/

https://www.merckmanuals.com/home/multimedia/figure/cvs_regulating_blood_pressure_renin

This protein, ACE2, is ubiquitous in every part of the body that interfaces with the circulatory system, particularly in vascular endothelial cells and pericytes, brain astrocytes, renal tubules and podocytes, pancreatic islet cells, bile duct and intestinal epithelial cells, and the seminiferous ducts of the testis, all of which SARS-CoV-2 can infect:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7167720/

https://www.frontiersin.org/articles/10.3389/fmed.2020.594495/full

https://www.frontiersin.org/articles/10.3389/fneur.2020.573095/full

SARS-CoV-2 infects a cell as follows:

https://www.nature.com/articles/s41401-020-0485-4

https://www.science.org/doi/10.1126/science.abb2507

https://www.sciencedirect.com/science/article/abs/pii/S1931312820306211

SARS-CoV-2 Spike proteins embedded in a cell can actually cause adjacent human cells to fuse together, forming syncytia/MGCs:

https://www.nature.com/articles/s41418-021-00782-3

https://pubmed.ncbi.nlm.nih.gov/33051876/

SARS-CoV-2’s viroporins, such as its Envelope protein, act as calcium ion channels, introducing calcium into infected cells:

https://www.nature.com/articles/s41422-021-00519-4

https://virologyj.biomedcentral.com/articles/10.1186/s12985-019-1182-0

The virus suppresses the natural interferon response, resulting in delayed inflammation:

https://www.nature.com/articles/s12276-021-00592-0

https://mdpi-res.com/d_attachment/viruses/viruses-12-01433/article_deploy/viruses-12-01433.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310780/

SARS-CoV-2 N protein can also directly activate the NLRP3 inflammasome:

https://www.nature.com/articles/s41467-021-25015-6

https://www.frontiersin.org/articles/10.3389/fimmu.2020.01021/full

SARS-CoV-2 suppresses the Nrf2 antioxidant pathway, reducing the body’s own endogenous antioxidant enzyme activity:

https://www.nature.com/articles/s41467-020-18764-3

https://ctajournal.biomedcentral.com/articles/10.1186/s13601-020-00362-7

https://mdpi-res.com/d_attachment/ijms/ijms-22-07963/article_deploy/ijms-22-07963.pdf

The suppression of ACE2 by binding with Spike causes a buildup of bradykinin that would otherwise be broken down by ACE2:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834250/

https://www.the-scientist.com/news-opinion/is-a-bradykinin-storm-brewing-in-covid-19--67876

This constant calcium influx into the cells results in (or is accompanied by) noticeable hypocalcemia, or low blood calcium:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292572/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041474/

https://www.sciencedirect.com/science/article/abs/pii/S1871402121000059

Bradykinin upregulates cAMP, cGMP, COX, and Phospholipase C activity. This results in prostaglandin release and vastly increased intracellular calcium signaling, which promotes highly aggressive ROS release and ATP depletion:
https://www.sciencedirect.com/science/article/abs/pii/S089158490700319X?via%3Dihub

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1218972/

https://pubmed.ncbi.nlm.nih.gov/2156053/

https://www.sciencedirect.com/topics/medicine-and-dentistry/bradykinin-b2-receptor-agonist

https://www.sciencedirect.com/topics/neuroscience/bradykinin

NADPH oxidase releases superoxide into the extracellular space:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556774/

https://www.pnas.org/content/110/21/8744

Superoxide radicals react with nitric oxide to form peroxynitrite:

https://pubmed.ncbi.nlm.nih.gov/8944624/

https://www.pnas.org/content/115/23/5839

Peroxynitrite reacts with the tetrahydrobiopterin cofactor needed by endothelial nitric oxide synthase, destroying it and “uncoupling” the eNOS enzymes, causing nitric oxide synthase to synthesize more superoxide instead (this means that every process that upregulates NOS activity now produces superoxide instead of nitric oxide):

https://pubmed.ncbi.nlm.nih.gov/24353182/

https://academic.oup.com/cardiovascres/article/73/1/8/316487

https://pubs.acs.org/doi/10.1021/bi9016632

This proceeds in a positive feedback loop until nitric oxide bioavailability in the circulatory system is depleted:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276137/

Dissolved nitric oxide gas produced constantly by eNOS serves many important functions, but it is also antiviral against SARS-like coronaviruses, preventing the palmitoylation of the viral Spike protein and making it harder for it to bind to host receptors:

https://journal.chestnet.org/article/S0012-3692(20)34397-X/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7111989/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754882/

The loss of NO allows the virus to begin replicating with impunity in the body (clearly, the virus has an evolutionary incentive to induce oxidative stress to destroy nitric oxide):

https://scitechdaily.com/nitric-oxide-a-possible-treatment-for-covid-19-only-substance-to-have-a-
direct-effect-on-sars-cov-2/

Those with endothelial dysfunction (i.e. hypertension, diabetes, obesity, old age, African-American race) have redox equilibrium issues to begin with, giving the virus an advantage:

https://www.nature.com/articles/s41392-020-00454-7

https://www.frontiersin.org/articles/10.3389/fphys.2020.605908/full

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430889/

https://pubmed.ncbi.nlm.nih.gov/19004510/

Due to the extreme cytokine release triggered by these processes, the body summons a great deal of neutrophils and monocyte-derived alveolar macrophages to the lungs:

https://www.frontiersin.org/articles/10.3389/fimmu.2021.652470/full

https://www.frontiersin.org/articles/10.3389/fimmu.2021.720109/full
Ivermectin shown as approved treatment/under evaluation on #NIH website
https://www.covid19treatmentguidelines.nih.gov/tables/table-2e/
https://archive.is/VNwhF