{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:21:30Z","timestamp":1783225290507,"version":"3.54.6"},"reference-count":86,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002674","name":"Russian Academy of Sciences","doi-asserted-by":"publisher","award":["01201363818"],"award-info":[{"award-number":["01201363818"]}],"id":[{"id":"10.13039\/501100002674","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>COVID-19 has specific characteristics that distinguish this disease from many other infections. We suggest that the pathogenesis of severe forms of COVID-19 can be associated with acidosis. This review article discusses several mechanisms potentially linking the damaging effects of COVID-19 with acidosis and shows the existence of a vicious cycle between the development of hypoxia and acidosis in COVID-19 patients. At the early stages of the disease, inflammation, difficulty in gas exchange in the lungs and thrombosis collectively contribute to the onset of acidosis. In accordance with the Verigo-Bohr effect, a decrease in blood pH leads to a decrease in oxygen saturation, which contributes to the exacerbation of acidosis and results in a deterioration of the patient\u2019s condition. A decrease in pH can also cause conformational changes in the S-protein of the virus and thus lead to a decrease in the affinity and avidity of protective antibodies. Hypoxia and acidosis lead to dysregulation of the immune system and multidirectional pro- and anti-inflammatory reactions, resulting in the development of a \u201ccytokine storm\u201d. In this review, we highlight the potential importance of supporting normal blood pH as an approach to COVID-19 therapy.<\/jats:p>","DOI":"10.3390\/biology10090852","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T21:59:45Z","timestamp":1630447185000},"page":"852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["The Role of Acidosis in the Pathogenesis of Severe Forms of COVID-19"],"prefix":"10.3390","volume":"10","author":[{"given":"Yury D.","family":"Nechipurenko","sequence":"first","affiliation":[{"name":"Laboratory DNA-Protein Recognition, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis A.","family":"Semyonov","sequence":"additional","affiliation":[{"name":"Institute of Molecular Medicine and Pathobiochemistry, Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk 660022, Russia"},{"name":"Institute of Biophysics Siberian Branch of Russian Academy of Sciences, Krasnoyarsk 660036, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2570-7331","authenticated-orcid":false,"given":"Igor A.","family":"Lavrinenko","sequence":"additional","affiliation":[{"name":"Department of Human and Animal Physiology, Faculty of Medicine and Biology, Voronezh State University, Voronezh 394018, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-6629","authenticated-orcid":false,"given":"Denis A.","family":"Lagutkin","sequence":"additional","affiliation":[{"name":"Department of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny 141701, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-6405","authenticated-orcid":false,"given":"Evgenii A.","family":"Generalov","sequence":"additional","affiliation":[{"name":"Department of Biophysics, Faculty of Physics, Lomonosov Moscow State University, Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-2770","authenticated-orcid":false,"given":"Anna Y.","family":"Zaitceva","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Analytical Methods and Devices, Institute for Analytical Instrumentation of the Russian Academy of Sciences, St. Petersburg 198095, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-9847","authenticated-orcid":false,"given":"Olga V.","family":"Matveeva","sequence":"additional","affiliation":[{"name":"Sendai Viralytics LLC, Acton, MA 117261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yegor E.","family":"Yegorov","sequence":"additional","affiliation":[{"name":"Laboratory of Cellular Bases for the Development of Malignant Diseases, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e00829","DOI":"10.1016\/j.idcr.2020.e00829","article-title":"A fatal case of COVID-19 due to metabolic acidosis following dysregulate inflammatory response (cytokine storm)","volume":"21","author":"Chhetri","year":"2020","journal-title":"IDCases"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.38025\/2078-1962-2020-97-3-25-30","article-title":"Acidosis and toxic hemolysis-goals of pathogenetic treatment of polyorgan pathology in COVID-19","volume":"97","author":"Lodyagin","year":"2020","journal-title":"Bull. 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