Significance: SARS-CoV-2, the virus causing COVID-19, affects every aspect of human life by challenging bodily, socio-economic and political systems at unprecedented levels. As vaccines become available, their distribution, safety and efficacy against emerging variants remain uncertain, and specific treatments are lacking.Recent Advances: Initially affecting the lungs, COVID-19 is a complex multi-systems disease that disturbs whole-body redox balance and can be long-lasting (Long-COVID). Numerous risk factors have been identified, but reasons for variations in susceptibility to infection, disease severity and outcome are poorly understood. The reactive species interactome (RSI) was recently introduced as a framework to conceptualise how cells and whole organisms sense, integrate and accommodate stress.
Critical Issues:We here consider COVID-19 as a redox disease, offering a holistic perspective of its effects on the human body, considering the vulnerability of complex interconnected systems with multi-organ/multi-level interdependencies. Host/viral glycan interactions underpin SARS-CoV-2's extraordinary efficiency in gaining cellular access, crossing the epithelial/endothelial barrier to spread along the vascular/lymphatic endothelium, and evading antiviral/antioxidant defences. An inflammation-