ABSTRACT
The paper considers the possible mechanism of the pathogenesis of COVID-19 caused by SARS-COV-2, associated with damage to red blood cells, which the authors attribute to the main key target that triggers a cascade of reactions leading to multiple organ failure. The paper presents morphological evidence for the presence of pathological forms of erythrocytes characteristic of various anemias in the blood vessels and parenchyma of damaged lungs of patients with COVID-19. The death of red blood cells leads to cell ischemia and anemia. The defeat of brain neurons, blood vessels and hematotissue barriers in organ systems is a consequence of ischemia due to the impossibility of transferring hemoglobin by damaged erythrocytes and ends at the terminal stages of the development of the disease with their dysfunction. Adaptive erythropoiesis with an increase in erythropoietin secretion is especially dangerous for patients suffering from hypertension, and then it is impossible, since all organs involved in the synthesis of erythropoietin are damaged. In this case, the synthesis of hemoglobin is also disrupted due to a deficiency of iron and cyancobolamin, whereas toxic iron and hemosiderin are deposited in the tissues.