text: Problems of Pathogenesis and Pathogenetic Therapy of COVID 19 from the Perspective of the General Theory of Pathological Systems General Pathological Processes The COVID 19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries Pro inflammatory processes extend far beyond the classical concepts of inflammation They manifest themselves in a variety of ways beginning with extreme physiology then allostasis at low grade inflammation and finally the shockogenic phenomenon of inflammatory systemic microcirculation The pathogenetic core of critical situations including COVID 19 is this phenomenon Microcirculatory abnormalities on the other hand lie at the heart of a specific type of general pathological process known as systemic inflammation SI Systemic inflammatory response cytokine release cytokine storm and thrombo inflammatory syndrome are all terms that refer to different aspects of SI As a result the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low grade systemic inflammation ChSLGI Diseases associated with ChSLGI on the other hand are risk factors for a severe COVID 19 course The review examines the role of hypoxia metabolic dysfunction scavenger receptors and pattern recognition receptors as well as the processes of the hemophagocytic syndrome in the systemic alteration and development of SI in COVID 19 