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Cellular Immune Response to COVID-19 and Potential Immune Modulators
1National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Frontiers in Immunology
|May 17, 2021
Summary
Understanding COVID-19 severity involves analyzing immune responses. Severe cases show distinct immune stages, guiding potential treatments like type I interferon (IFN) and immunoglobulin therapies.
Area of Science:
- Immunology
- Virology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents heterogeneous clinical outcomes.
- Transmission occurs mainly through droplets and contact.
- Factors influencing COVID-19 outcomes, particularly host-related immune responses, require further characterization.
Purpose of the Study:
- To elucidate the relationship between host immune responses and COVID-19 severity.
- To identify distinct stages of immune response in fatal COVID-19 cases.
- To propose stage-specific therapeutic interventions for severe COVID-19.
Main Methods:
- Analysis of immune response kinetics in patients with varying COVID-19 severity.
- Characterization of immune profiles in mild, severe, and fatal COVID-19 cases.
- Literature review on immune responses in infectious diseases.
Main Results:
- COVID-19 severity is primarily linked to host cellular immune responses.
- Fatal severe COVID-19 involves a three-stage immune response: hypofunction, hyperactivation, and anergy.
- Mild and recovering severe cases exhibit effective viral clearance via normal immune responses.
Conclusions:
- Type I interferon (IFN) may benefit patients in the hypofunctional stage of severe COVID-19.
- Intravenous immunoglobulin (IVIG) and glucocorticoid therapy are suggested for the hyperactivation stage.
- Anticoagulation with low molecular weight heparin (LMWH) and antibiotic therapy are recommended during the hyperactivation stage.
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