The study looked at 173 COVID-19 patients who became severe and compared those who died with those who recovered. Significant differences in blood parameters appeared only in the first week after deterioration: in patients who did not survive, there was a rapid increase in lactate dehydrogenase and a decrease in D-dimer. Based on these findings, the authors hypothesize that the mechanism of death in COVID-19 is a sudden increase in glycolysis during deterioration caused by a lack of oxygen and virus-induced mitochondrial damage. This leads to a disruption of the metabolic balance in the body and blood clotting disorders, which results in death. The authors suggest that early identification of patients with imminent deterioration and rapid intervention with artificial ventilation and treatment aimed at reducing glycolysis could reduce mortality. Further experimental and clinical studies are needed to verify this hypothesis and to identify high-risk patients.