Abstract
A severe pandemic of CoronaVirus disease 2019 (COVID-19), according to World Health Organization (WHO), appeared in China in December 2019, and spread rapidly. The majority of the patients had mild symptoms and good prognosis after recovery; however some patients developed severe inflammatory reaction and passed away from multiple organ complications. The novel coronavirus, Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is a beta-coronavirus and is similar with the Severe Acute Respiratory Syndrome Corona Virus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). SARS-CoV-2 and -1 have the same host receptor, the angiotensin-converting enzyme 2 (ACE2). The pathogenesis of SARS-CoV-2 infection in humans remains unclear. The immune response is essential to control and reduce SARS-CoV-1 and -2 infections, however, irregular and exaggerated immune responses may lead to the immunopathology of the disease and the lung lesions. This article presents the immunological features of SARS-CoV-2 infection and its potential pathogenesis based on the recent observations of the International literature.
Highlights
Coronavirus disease 2019 (COVID-19) consists an acute respiratory clinical syndrome caused by a novel coronavirus which emerged in Wuhan in December 2019
The novel coronavirus, Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) is a betacoronavirus and is similar with the Severe Acute Respiratory Syndrome CoronaVirus (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which were responsible for respiratory infections characterized by poor prognosis over the last 20 years [1]
Previous studies have shown that the pathogenesis of SARS-CoV and MERSCoV are not yet fully elucidated and it is possible that viraland host factors are implicated in it as hosts factors are responsible for an exaggerated immune response which may result in damage to the lung tissue and functional disorder [3,4,5]
Summary
Coronavirus disease 2019 (COVID-19) consists an acute respiratory clinical syndrome caused by a novel coronavirus which emerged in Wuhan in December 2019. Elevated serum Interleukin (IL) -6 levels have been found in patients with SARS-CoV-1, with which SARS-CoV-2 is closely linked, and are associated with respiratory failure, Acute Respiratory Distress Syndrome (ARDS), and poor clinical outcome [7, 8]. It has been estimated that 20% of COVID-19 patients will have severe symptoms of pneumonia, leading to ARDS [9]. This complication is similar to the ARDS caused by the release of cytokines and the Haemophagocytic LymphoHistiocytosis Syndrome (HLHS) previously observed in patients with SARS-CoV and MERS-CoV as well as patients with B acute lymphoblastic leukemia receiving genetically modified autologous T-lymphocytes (CAR-T cells) [10]
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