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The Immune Response and Effectiveness of COVID-19 Therapies

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Clinical, Biological and Molecular Aspects of COVID-19

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

  1. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Fauci AS, Lane HC, Redfield RR (2020) Covid-19 – navigating the uncharted. N Engl J 382(13):1268–1269

    Article  CAS  Google Scholar 

  3. 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

    Article  Google Scholar 

  4. 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

    Article  CAS  Google Scholar 

  5. 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

    Article  CAS  Google Scholar 

  6. 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

  7. 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

    Article  CAS  Google Scholar 

  8. 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

    Article  CAS  Google Scholar 

  9. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. 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

    Article  CAS  Google Scholar 

  11. 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

    Article  CAS  Google Scholar 

  12. 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

    Article  CAS  Google Scholar 

  13. 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

    Article  CAS  Google Scholar 

  14. Acharya D, Liu G, Gack MU (2020) Dysregulation of type I interferon responses in COVID-19. Nat Rev Immunol 20(7):397–398

    Article  CAS  Google Scholar 

  15. 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

    Article  CAS  Google Scholar 

  16. 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

    Article  CAS  Google Scholar 

  17. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. 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]

  19. Campbell CM, Kahwash R (2020) Will complement inhibition be the new target in treating COVID-19–related systemic thrombosis? Circulation 141(22):1739–1741

    Article  CAS  Google Scholar 

  20. 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

  21. 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

    Article  CAS  Google Scholar 

  22. 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

    Article  CAS  Google Scholar 

  23. 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

    Article  Google Scholar 

  24. 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

    Article  CAS  Google Scholar 

  25. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. 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

    Article  Google Scholar 

  27. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. 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

    Article  CAS  Google Scholar 

  29. 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

    Article  CAS  Google Scholar 

  30. 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

    Article  CAS  Google Scholar 

  31. 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

    Article  CAS  Google Scholar 

  32. 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

  33. Bersanelli M (2020) Controversies about COVID-19 and anticancer treatment with immune checkpoint inhibitors. Immunotherapy 12(5):269–273

    Article  CAS  Google Scholar 

  34. Ye Q, Wang B, Mao J (2020) The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Inf 80(6):607–613

    Article  CAS  Google Scholar 

  35. 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

    Article  CAS  Google Scholar 

  36. Cao X (2020) COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol 20(5):269–270

    Article  CAS  Google Scholar 

  37. 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

    CAS  Google Scholar 

  38. 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

    Article  CAS  Google Scholar 

  39. 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

    Article  CAS  Google Scholar 

  40. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. 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

    Article  CAS  PubMed Central  Google Scholar 

  42. 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

  43. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. 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

  45. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. 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

    Article  CAS  Google Scholar 

  47. 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

  48. 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

    Article  CAS  Google Scholar 

  49. 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

    Article  CAS  Google Scholar 

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Correspondence to Amirhossein Sahebkar .

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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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