After treating 100s of patients here in US , I think COVID-19 does not cause sever viral pneumonia or ARDS as it was thought initially . All the lung mechanics are intact and lung compliance on ventilator appears normal . COVID-19 is a very nasty virus that cause unique effect as it affect the hemoglobin molecules in the blood and that is why sever hypoxrmia and multi organ failure develop due to sever decrease in Hb carrying capacity caused by binding and inhibiting the heme molecule of the globin . And that how Hydroxychloroquine and Flaviprivir work through inhibiting the attachment of the virus coat protein to the Porphyrin molecule. Ventilations and ARDS protocols may induce ventilator induced lung injury rather than treating the condition . The infiltrate on the X ray and CT scan is caused by oxidative stress of the accumulation of the heme extracted by the virus in the alveoli causing chemical pneumonitis not viral pneumonia .The virus is dependent on the Porphyrin that is why it is more sever in men and grow faster with glycosylated Hb and that is why it is bad in diabetics and older patients . The higher the Hb F and A2 makes it better as there is no B globing to attach so it is not very bad in children . Hyperbaric oxygen and blood transfusion may transiently help. The virus induce condition high altitude , methemoglobinemia and carbon monoxide poisoning.
It’s a New virus causing new disease . No probability of being human mad , mutated animal virus ( zoonotic ) . It seems it cause systemic illness initially by the virus itself and by massive immune response to it . It affects lungs , heart , hemoglobin , CNS, kidneys , vessels and may be coagulation.