Immune system and renin-angiotensin-aldosterone system dysregulation with associated cytokine release syndrome may be a key feature of early stage of SARS-CoV-2 organotropism and infection. Following viral mediated brain injury, dysregulated neurochemical activity may cause neurogenic stress cardiomyopathy, which is characterized by transient myocardial dysfunction and arrhythmias. Cardiomyopathy along with acute acute inflammatory thromboembolism and endotheliitis (fragile endothelium) might at least partially explain the underlying mechanisms of rapidly evolving life-threatening COVID-19. Further studies are clearly required to explore these complex pathologies.

中文翻译：

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COVID-19 中脆弱的内皮和大脑神经化学活性失调。

免疫系统和肾素-血管紧张素-醛固酮系统失调以及相关的细胞因子释放综合征可能是 SARS-CoV-2 器官趋向性和感染早期的一个关键特征。病毒介导的脑损伤后，神经化学活性失调可能导致神经源性应激性心肌病，其特征是短暂的心肌功能障碍和心律失常。心肌病以及急性炎症性血栓栓塞和内皮炎（脆性内皮）可能至少部分解释了快速演变的危及生命的 COVID-19 的潜在机制。显然需要进一步的研究来探索这些复杂的病理学。