Abstract
Severe cases of coronavirus disease 2019 (COVID-19) often experience hyper-inflammatory reactions, acute respiratory distress syndrome (ARDS), blood clotting, and organ damage. The most prominent immunopathology of advanced COVID-19 is cytokine release syndrome, or "cytokine storm" which is attributed to a defect of immune-regulating mechanisms. This study aimed to evaluate the role of regulatory T cells (Tregs) as one of the main cells that maintain immune homeostasis. A systematic search was performed on PubMed, Scopus and Google Scholar. All English articles related to Treg's role in COVID-19 were extracted and evaluated by two researchers independently. Study eligibility was assessed based on modified Evidence-based librarianship (EBL) checklist. Nineteen eligible studies comparing Treg cells in COVID-19 patients with the control group or comparing alterations of this cell in severe and moderate patients were evaluated. Currently, there is no consensus regarding the increase or decrease of Tregs in COVID-19 patients compared to the control group. However, it was observed that Tregs in severe COVID-19 patients were significantly lower than moderate patients, resulting in uncontrolled inflammation and cytokine storm. Regulatory T cells can be one of the determinants of disease severity and prognosis in patients with COVID-19 by inhibiting rampant inflammation and preventing cytokine storms.
Highlights
T cells need to induce SARS-CoV-2-specific immune responses by detecting viral antigens through antigen receptors (TCR)
Regulatory T Cells in COVID-19 in COVID-19 patients compared to the control group.[10,11]
In this review, we evaluated the trend of Treg changes in COVID-19 patients compared to the control group at different clinical stages of the disease
Summary
T cells need to induce SARS-CoV-2-specific immune responses by detecting viral antigens through antigen receptors (TCR). The most critical population of Tregs, which expresses Foxp[3], can limit the activation, proliferation, and effector roles in series of immune cells.[5-7]. This study aimed to evaluate the role of regulatory T cells (Tregs) as one of the main cells that maintain immune homeostasis. Results: Nineteen eligible studies comparing Treg cells in COVID-19 patients with the control group or comparing alterations of this cell in severe and moderate patients were evaluated. It was observed that Tregs in severe COVID-19 patients were significantly lower than moderate patients, resulting in uncontrolled inflammation and cytokine storm. Conclusion: Regulatory T cells can be one of the determinants of disease severity and prognosis in patients with COVID-19 by inhibiting rampant inflammation and preventing cytokine storms.
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