Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19
As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID‐19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease...
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| Published in | Allergy (Copenhagen) Vol. 75; no. 7; pp. 1564 - 1581 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Denmark
Blackwell Publishing Ltd
01.07.2020
John Wiley and Sons Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID‐19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute‐phase reactants, and serum biochemistry in COVID‐19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1‐week, self‐limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM‐, IgA‐, and IgG‐type virus‐specific antibodies levels are important measurements to predict population immunity against this disease and whether cross‐reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID‐19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine‐secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute‐phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients. |
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| AbstractList | As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID-19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute-phase reactants, and serum biochemistry in COVID-19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1-week, self-limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM-, IgA-, and IgG-type virus-specific antibodies levels are important measurements to predict population immunity against this disease and whether cross-reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID-19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine-secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute-phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients. Abstract As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID‐19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute‐phase reactants, and serum biochemistry in COVID‐19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1‐week, self‐limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM‐, IgA‐, and IgG‐type virus‐specific antibodies levels are important measurements to predict population immunity against this disease and whether cross‐reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID‐19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine‐secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute‐phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients. |
| Author | Akdis, Cezmi A. Akdis, Mübeccel Veen, Willem Nadeau, Kari O’Mahony, Liam Sokolowska, Milena Gao, Yadong Azkur, Ahmet Kursat Brüggen, Marie‐Charlotte Azkur, Dilek |
| AuthorAffiliation | 5 Department of Dermatology University Hospital Zurich Zurich Switzerland 8 Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland 9 Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China 2 Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland 3 Division of Pediatric Allergy and Immunology Department of Pediatrics Faculty of Medicine University of Kirikkale Kirikkale Turkey 4 Christine Kühne‐Center for Allergy Research and Education Davos Switzerland 6 Faculty of Medicine University Zurich Zurich Switzerland 7 Hochgebirgsklinik Davos Davos Switzerland 1 Department of Virology Faculty of Veterinary Medicine University of Kirikkale Kirikkale Turkey 10 Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA USA |
| AuthorAffiliation_xml | – name: 7 Hochgebirgsklinik Davos Davos Switzerland – name: 5 Department of Dermatology University Hospital Zurich Zurich Switzerland – name: 9 Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China – name: 8 Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland – name: 2 Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland – name: 4 Christine Kühne‐Center for Allergy Research and Education Davos Switzerland – name: 1 Department of Virology Faculty of Veterinary Medicine University of Kirikkale Kirikkale Turkey – name: 3 Division of Pediatric Allergy and Immunology Department of Pediatrics Faculty of Medicine University of Kirikkale Kirikkale Turkey – name: 6 Faculty of Medicine University Zurich Zurich Switzerland – name: 10 Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA USA |
| Author_xml | – sequence: 1 givenname: Ahmet Kursat orcidid: 0000-0002-5597-8917 surname: Azkur fullname: Azkur, Ahmet Kursat organization: University of Kirikkale – sequence: 2 givenname: Mübeccel orcidid: 0000-0003-0554-9943 surname: Akdis fullname: Akdis, Mübeccel organization: University of Zurich – sequence: 3 givenname: Dilek orcidid: 0000-0002-4396-9087 surname: Azkur fullname: Azkur, Dilek organization: University of Kirikkale – sequence: 4 givenname: Milena orcidid: 0000-0001-9710-6685 surname: Sokolowska fullname: Sokolowska, Milena organization: University of Zurich – sequence: 5 givenname: Willem surname: Veen fullname: Veen, Willem organization: University of Zurich – sequence: 6 givenname: Marie‐Charlotte surname: Brüggen fullname: Brüggen, Marie‐Charlotte organization: Hochgebirgsklinik Davos – sequence: 7 givenname: Liam orcidid: 0000-0003-4705-3583 surname: O’Mahony fullname: O’Mahony, Liam organization: University College Cork – sequence: 8 givenname: Yadong orcidid: 0000-0003-1251-7608 surname: Gao fullname: Gao, Yadong organization: Zhongnan Hospital of Wuhan University – sequence: 9 givenname: Kari orcidid: 0000-0002-2146-2955 surname: Nadeau fullname: Nadeau, Kari organization: Stanford University – sequence: 10 givenname: Cezmi A. orcidid: 0000-0001-8020-019X surname: Akdis fullname: Akdis, Cezmi A. email: akdisac@siaf.uzh.ch organization: Christine Kühne‐Center for Allergy Research and Education |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32396996$$D View this record in MEDLINE/PubMed |
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| Snippet | As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus... Abstract As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of... |
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| SubjectTerms | Animals Antibodies, Viral - immunology Antiviral drugs Asymptomatic Autopsy Betacoronavirus - chemistry Betacoronavirus - immunology Cell activation Coronaviridae Coronavirus Infections - blood Coronavirus Infections - immunology Coronavirus Infections - virology Coronaviruses COVID-19 Cytokine storm Cytokines Cytokines - immunology Eosinopenia Eosinophils - immunology Epitopes, B-Lymphocyte - immunology Epitopes, T-Lymphocyte - immunology Herd immunity Humans immune response Immunity, Innate Immunoglobulin A Immunoglobulin G Immunoglobulin M immunologic tests Immunology immunopathology infections Lymphocytes - immunology Lymphocytes T Lymphopenia Medical personnel Occupational exposure pandemic Pandemics Patients Pneumonia, Viral - blood Pneumonia, Viral - immunology Pneumonia, Viral - virology Prevention Respiratory diseases Respiratory distress syndrome Review SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Vaccines Viral infections virus Zoonoses Zoonoses - immunology Zoonoses - virology |
| Title | Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19 |
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