Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly pathogenic with relatively high mortality and morbidity. In addition to pneumonia, acute respiratory distress syndrome, and microembolic disorder, a high proportion of patients with SARS-CoV-2 develop lymphopenia and cytokine storm disorder. This review explores the underlying mechanisms behind the pathogenesis of SARS-CoV-2, especially the immune mechanisms, which could be potentially used as therapeutic targets for the management of COVID-19.
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References
Shoenfeld Y (2020) Corona (COVID-19) time musings: our involvement in COVID-19 pathogenesis, diagnosis, treatment and vaccine planning. Autoimmun Rev 19(6):102538. https://doi.org/10.1016/j.autrev.2020.102538
Fauci AS, Lane HC, Redfield RR (2020) Covid-19 – navigating the uncharted. N Engl J 382(13):1268–1269
Li X, Geng M, Peng Y, Meng L, Lu S (2020) Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal 10(2):102–108
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ et al (2020) COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 395(10229):1033–1034
Ulrich H, Pillat MM (2020) CD147 as a target for COVID-19 treatment: suggested effects of azithromycin and stem cell engagement. Stem Cell Rev Rep 16(3):434–440
Acosta FASAD (2020) Entry of SARS-CoV2 through the basal surface of alveolar endothelial cells–A proposed mechanism mediated by CD147 in COVID-19. Preprints 2020050359. https://doi.org/10.20944/preprints202005.0359.v1
Tufan A, GÜLER AA, Matucci-Cerinic M (2020) COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci 50(SI-1):620–632
Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X et al (2020) COVID-19 infection: the perspectives on immune responses. Cell Death Differ 27(5):1451–1454
Nguyen A, David JK, Maden SK, Wood MA, Weeder BR, Nellore A et al (2020) Human leukocyte antigen susceptibility map for SARS-CoV-2. J Virol 94(13):e00510–e00520. https://doi.org/10.1128/JVI.00510-20
Giamarellos-Bourboulis EJ, Netea MG, Rovina N, Akinosoglou K, Antoniadou A, Antonakos N et al (2020) Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell Host Microbe 27(6):992–1000.e3
Merad M, Martin JC (2020) Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol 20(6):355–362
Zhou Z, Ren L, Zhang L, Zhong J, Xiao Y, Jia Z et al (2020) Heightened innate immune responses in the respiratory tract of COVID-19 patients. Cell Host Microbe 27(6):883–890.e2
Trouillet-Assant S, Viel S, Gaymard A, Pons S, Richard JC, Perret M et al (2020) Type I IFN immunoprofiling in COVID-19 patients. J Allergy Clin Immunol 146(1):206–208.e2
Acharya D, Liu G, Gack MU (2020) Dysregulation of type I interferon responses in COVID-19. Nat Rev Immunol 20(7):397–398
Park A, Iwasaki A (2020) Type I and type III interferons–induction, signaling, evasion, and application to combat COVID-19. Cell Host Microbe 27(6):870–878
Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M (2020) The cytokine storm in COVID-19: an overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev 53:25–32
McGonagle D, Sharif K, O’Regan A, Bridgewood C (2020) Interleukin-6 use in COVID-19 pneumonia related macrophage activation syndrome. Autoimmun Rev 19(6):102537. https://doi.org/10.1016/j.autrev.2020.102537
Park MD (2020) Macrophages: a Trojan horse in COVID-19? Nat Rev Immunol Apr 17:1. https://doi.org/10.1038/s41577-020-0317-2. [Epub ahead of print]
Campbell CM, Kahwash R (2020) Will complement inhibition be the new target in treating COVID-19–related systemic thrombosis? Circulation 141(22):1739–1741
Mastaglio S, Ruggeri A, Risitano AM, Angelillo P, Yancopoulou D, Mastellos DC et al (2020) The first case of COVID-19 treated with the complement C3 inhibitor AMY-101. Clin Immunol 215:108450. doi: https://doi.org/10.1016/j.clim.2020.108450
Risitano AM, Mastellos DC, Huber-Lang M, Yancopoulou D, Garlanda C, Ciceri F et al (2020) Complement as a target in COVID-19? Nat Rev Immunol 20(6):343–344
Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J et al (2020) Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res 220:1–13
Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LF (2020) The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol 20:1–12
Wu D, Yang XO (2020) TH17 responses in cytokine storm of COVID-19: an emerging target of JAK2 inhibitor Fedratinib. J Microbiol Immunol Infect 53(3):368–370
Zhang C, Wu Z, Li JW, Zhao H, Wang GQ (2020) The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents 55(5):105954. https://doi.org/10.1016/j.ijantimicag.2020.105954
Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ et al (2020) Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 5(1):1–3
Diao B, Wang C, Tan Y, Chen X, Liu Y, Ning L et al (2020) Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19). Front Immunol 11:827. https://doi.org/10.3389/fimmu.2020.00827
Zheng HY, Zhang M, Yang CX, Zhang N, Wang XC, Yang XP et al (2020) Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients. Cell Mol Immunol 17(5):541–543
Wilk AJ, Rustagi A, Zhao NQ, Roque J, Martínez-Colón GJ, McKechnie JL et al (2020) A single-cell atlas of the peripheral immune response in patients with severe COVID-19. Nat Med 26(7):1070–1076
Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H et al (2020) Clinical and immunologic features in severe and moderate forms of coronavirus disease 2019. J Clin Invest 130(5):2620–2629
Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D et al (2020) Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol 17(5):533–535
Pickles OJ, Lee LY, Starkey T, Freeman-Mills L, Olsson-Brown A, Cheng V et al (2020) Immune checkpoint blockade: releasing the breaks or a protective barrier to COVID-19 severe acute respiratory syndrome? Br J Cancer Jun 16;1–3. https://doi.org/10.1038/s41416-020-0930-7. Online ahead of print
Bersanelli M (2020) Controversies about COVID-19 and anticancer treatment with immune checkpoint inhibitors. Immunotherapy 12(5):269–273
Ye Q, Wang B, Mao J (2020) The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Inf 80(6):607–613
Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF et al (2020) On the alert for cytokine storm: immunopathology in COVID-19. Arthritis Rheum 72:1059–1063
Cao X (2020) COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol 20(5):269–270
Bermejo-Martin JF, Almansa R, Menéndez R, Mendez R, Kelvin DJ, Torres A (2020) Lymphopenic community acquired pneumonia as signature of severe COVID-19 infection. J Inf Secur 80(5):e23–e24
Chen L, Xiong J, Bao L, Shi Y (2020) Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis 20(4):398–400
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J et al (2020) Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A 117(17):9490–9496
Rojas M, Rodríguez Y, Monsalve DM, Acosta-Ampudia Y, Camacho B, Gallo JE et al (2020) Convalescent plasma in Covid-19: possible mechanisms of action. Autoimmun Rev 19(7):102554. https://doi.org/10.1016/j.autrev.2020.102554
Jawhara S (2020) Could intravenous immunoglobulin collected from recovered coronavirus patients protect against COVID-19 and strengthen the immune system of new patients? Int J Mol Sci 21(7):2272. https://doi.org/10.3390/ijms21072272
Xie Y, Cao S, Dong H, Li Q, Chen E, Zhang W et al (2020) Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. J Infect Apr 10;S0163-4453(20):30172–30179. https://doi.org/10.1016/j.jinf.2020.03.044. Online ahead of print
Ritchie AI, Singanayagam A (2020) Immunosuppression for hyperinflammation in COVID-19: a double-edged sword? Lancet 395(10230):1111. https://doi.org/10.1016/S0140-6736(20)30691-7
Lang FM, Lee KMC, Teijaro JR, Becher B, Hamilton JA (2020) GM-CSF-based treatments in COVID-19: reconciling opposing therapeutic approaches. Nat Rev Immunol Jun 23;1–8. https://doi.org/10.1038/s41577-020-0357-7. Online ahead of print
Liu B, Li M, Zhou Z, Guan X, Xiang Y (2020) Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)? J Autoimmun 111:102452. https://doi.org/10.1016/j.jaut.2020.102452
Feldmann M, Maini RN, Woody JN, Holgate ST, Winter G, Rowland M et al (2020) Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed. Lancet 395(10234):1407–1409
Theoharides T, Conti P (2020) Dexamethasone for COVID-19? Not so fast. J Biol Regul Homeost Agents Jun 4;34(3). https://doi.org/10.23812/20-EDITORIAL_1-5. Online ahead of print
Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A et al (2020) Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med 382(24):2327–2336
Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y et al (2020) Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 395(10236):1569–1578
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Tavasolian, F. et al. (2021). The Immune Response and Effectiveness of COVID-19 Therapies. In: Guest, P.C. (eds) Clinical, Biological and Molecular Aspects of COVID-19. Advances in Experimental Medicine and Biology(), vol 1321. Springer, Cham. https://doi.org/10.1007/978-3-030-59261-5_10
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DOI: https://doi.org/10.1007/978-3-030-59261-5_10
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