An update: the emerging evidence of complement involvement in COVID-19

Med Microbiol Immunol. 2021 Jun;210(2-3):101-109. doi: 10.1007/s00430-021-00704-7. Epub 2021 Apr 3.

Abstract

The current outbreak of coronavirus disease 2019 (COVID-19) has affected people around the world. Typically, COVID-19 originates in the lung, but lately it can extend to other organs and lead to tissue injury and multiorgan failure in severe patients, such as acute respiratory distress syndrome (ARDS), kidney failure and sepsis or systemic inflammation. Given that COVID-19 has been detected in a range of other organs, the COVID-19-associated disease is an alert of aberrant activation of host immune response which drives un-controlled inflammation that affects multiple organs. Complement is a vital component of innate immunity where it forms the first line of defense against potentially harmful microbes, but its role in COVID-19 is still not clear. Notably, the abnormal activation and continuous deposits of complement components were identified in the pre-clinical samples from COVID-19 patients, which have been confirmed in animal models. Recent evidence has revealed that the administration of complement inhibitors leads to relieve inflammatory response in ARDS. Hence, we speculate that the targeting complement system could be a potential treatment option for organ damage in COVID-19 patients.

Keywords: COVID-19; Complement; Complement inhibitor; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Animals
  • COVID-19 / immunology*
  • COVID-19 / pathology
  • Complement Inactivating Agents / pharmacology
  • Complement System Proteins / immunology*
  • Humans
  • Immunity, Innate*
  • Inflammation / immunology*
  • Inflammation / virology
  • Lung / immunology
  • Lung / virology
  • Respiratory Distress Syndrome / immunology*
  • Respiratory Distress Syndrome / virology

Substances

  • Complement Inactivating Agents
  • Complement System Proteins