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Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art

COVID-19 has become a worldwide pandemic caused by the novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe cases of COVID-19 have accounted for 10–20% of all infections, leading to more than 500,000 deaths. Increasing evidence has suggested that the inflammat...

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Autores principales: Zhang, Yinhua, Chen, Yuanyuan, Meng, Zhongji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680845/
https://www.ncbi.nlm.nih.gov/pubmed/33240265
http://dx.doi.org/10.3389/fimmu.2020.577442
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author Zhang, Yinhua
Chen, Yuanyuan
Meng, Zhongji
author_facet Zhang, Yinhua
Chen, Yuanyuan
Meng, Zhongji
author_sort Zhang, Yinhua
collection PubMed
description COVID-19 has become a worldwide pandemic caused by the novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe cases of COVID-19 have accounted for 10–20% of all infections, leading to more than 500,000 deaths. Increasing evidence has suggested that the inflammatory cytokine storm originating from the anti-SARS-CoV-2 immune response plays an important role in the pathogenesis of critically ill patients with COVID-19, which leads to mixed antagonistic response syndrome (MARS). In the early stage of severe COVID-19, systemic inflammatory response syndrome causes acute respiratory distress syndrome, multiple organ dysfunction syndrome, and even multiple organ failure. In the late stage of severe disease, increased production of anti-inflammatory cytokines drives the immune response to become dominated by compensatory anti-inflammatory response syndrome, which leads to immune exhaustion and susceptibility to secondary infections. Therefore, precise immunomodulation will be beneficial for patients with severe COVID-19, and immunosuppressive or immune enhancement therapy will depend on the disease course and immune status. This review summarizes the current understanding of the immunopathogenesis of severe COVID-19, especially the role of the inflammatory cytokine storm in disease progression. Immune indicators and immunotherapy strategies for severe COVID-19 are reviewed and the potential implications discussed.
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spelling pubmed-76808452020-11-24 Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art Zhang, Yinhua Chen, Yuanyuan Meng, Zhongji Front Immunol Immunology COVID-19 has become a worldwide pandemic caused by the novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe cases of COVID-19 have accounted for 10–20% of all infections, leading to more than 500,000 deaths. Increasing evidence has suggested that the inflammatory cytokine storm originating from the anti-SARS-CoV-2 immune response plays an important role in the pathogenesis of critically ill patients with COVID-19, which leads to mixed antagonistic response syndrome (MARS). In the early stage of severe COVID-19, systemic inflammatory response syndrome causes acute respiratory distress syndrome, multiple organ dysfunction syndrome, and even multiple organ failure. In the late stage of severe disease, increased production of anti-inflammatory cytokines drives the immune response to become dominated by compensatory anti-inflammatory response syndrome, which leads to immune exhaustion and susceptibility to secondary infections. Therefore, precise immunomodulation will be beneficial for patients with severe COVID-19, and immunosuppressive or immune enhancement therapy will depend on the disease course and immune status. This review summarizes the current understanding of the immunopathogenesis of severe COVID-19, especially the role of the inflammatory cytokine storm in disease progression. Immune indicators and immunotherapy strategies for severe COVID-19 are reviewed and the potential implications discussed. Frontiers Media S.A. 2020-11-09 /pmc/articles/PMC7680845/ /pubmed/33240265 http://dx.doi.org/10.3389/fimmu.2020.577442 Text en Copyright © 2020 Zhang, Chen and Meng http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Zhang, Yinhua
Chen, Yuanyuan
Meng, Zhongji
Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title_full Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title_fullStr Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title_full_unstemmed Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title_short Immunomodulation for Severe COVID-19 Pneumonia: The State of the Art
title_sort immunomodulation for severe covid-19 pneumonia: the state of the art
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680845/
https://www.ncbi.nlm.nih.gov/pubmed/33240265
http://dx.doi.org/10.3389/fimmu.2020.577442
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