Abstract
The recent novel coronavirus disease (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seeing a rapid increase in infected patients worldwide. The host immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations. SARS-CoV-2 not only activates antiviral immune responses, but can also cause uncontrolled inflammatory responses characterized by marked pro-inflammatory cytokine release in patients with severe COVID-19, leading to lymphopenia, lymphocyte dysfunction, and granulocyte and monocyte abnormalities. These SARS-CoV-2-induced immune abnormalities may lead to infections by microorganisms, septic shock, and severe multiple organ dysfunction. Therefore, mechanisms underlying immune abnormalities in patients with COVID-19 must be elucidated to guide clinical management of the disease. Moreover, rational management of the immune responses to SARS-CoV-2, which includes enhancing anti-viral immunity while inhibiting systemic inflammation, may be key to successful treatment. In this review, we discuss the immunopathology of COVID-19, its potential mechanisms, and clinical implications to aid the development of new therapeutic strategies against COVID-19.
Highlights
The current coronavirus disease 2019 (COVID-19) outbreak is a worldwide emergency, as its rapid spread and high mortality rate has caused severe disruptions
We summarize the immune characteristics of COVID-19 and discuss the potential mechanisms of severe acute respiratory syndrome (SARS)-CoV-2-induced immune changes, their effect on disease outcomes, and their implications for potential COVID-19 treatments
Our study showed that cytokine levels, including IL2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α and IFN-γ, are elevated in severe and critical COVID-19 cases, IL-6 and IL-10, which showed a dramatic increase in levels.[27] concomitant with disease progression.[42] (3) the SARSCoV-2 virus may directly destroy lymphatic organs including the
Summary
Li Yang[1], Shasha Liu[1], Jinyan Liu[1], Zhixin Zhang[2], Xiaochun Wan[3], Bo Huang[4], Youhai Chen[5] and Yi Zhang 1. The host immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations. SARS-CoV-2 activates antiviral immune responses, but can cause uncontrolled inflammatory responses characterized by marked pro-inflammatory cytokine release in patients with severe COVID-19, leading to lymphopenia, lymphocyte dysfunction, and granulocyte and monocyte abnormalities. These SARS-CoV-2-induced immune abnormalities may lead to infections by microorganisms, septic shock, and severe multiple organ dysfunction. Mechanisms underlying immune abnormalities in patients with COVID-19 must be elucidated to guide clinical management of the disease. We discuss the immunopathology of COVID-19, its potential mechanisms, and clinical implications to aid the development of new therapeutic strategies against COVID-19
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