The unleashing of the immune system in COVID-19 and sepsis: the calm before the storm?

Inflamm Res. 2020 Aug;69(8):757-763. doi: 10.1007/s00011-020-01366-6. Epub 2020 May 28.

Abstract

The novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sorely testing health care systems and economies around the world and is rightly considered as the major health emergency in a century. Despite the course of the disease appearing to be mild in many cases, a significant proportion of symptomatic patients develop pneumonia requiring hospitalisation or progress to manifest respiratory complications leading to intensive care treatment. Potential interventions for SARS-CoV2-associated pneumonia are being tested, some of which holding promise, but as of today none of these has yet demonstrated outstanding efficacy in treating COVID-19. In this article, we discuss fresh perspectives and insights into the potential role of immune dysregulation in COVID-19 as well as similarities with systemic inflammatory response in sepsis and the rationale for exploring novel treatment options affecting host immune response.

Keywords: Checkpoint inhibitors; Covid-19; Cytokine storm; Immune dysregulation; Inflammatory receptors; Sepsis.

MeSH terms

  • Betacoronavirus
  • Biomarkers
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / therapy
  • Cytokine Release Syndrome / virology
  • Cytokines / immunology
  • Humans
  • Immune System / virology*
  • Immunity, Innate
  • Inflammation
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / therapy
  • SARS-CoV-2
  • Sepsis / complications
  • Sepsis / diagnosis*
  • Sepsis / immunology*
  • Sepsis / therapy

Substances

  • Biomarkers
  • Cytokines