COVID-19 disease and immune dysregulation

Ethan Davitt; Colin Davitt; Monty B Mazer; Sathya S Areti; Richard S Hotchkiss; Kenneth E Remy

doi:10.1016/j.beha.2022.101401

COVID-19 disease and immune dysregulation

Best Pract Res Clin Haematol. 2022 Sep;35(3):101401. doi: 10.1016/j.beha.2022.101401. Epub 2022 Oct 15.

Authors

Ethan Davitt¹, Colin Davitt², Monty B Mazer³, Sathya S Areti⁴, Richard S Hotchkiss⁵, Kenneth E Remy⁶

Affiliations

¹ School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
² Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
³ Department of Pediatrics, University Hospitals of Cleveland, Cleveland, OH, USA; School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
⁴ Department of Internal Medicine, University Hospitals of Cleveland, Cleveland, OH, USA.
⁵ School of Medicine, Washington University in St. Louis, St. Louis, MO, USA; Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
⁶ Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, OH, USA; Department of Internal Medicine, University Hospitals of Cleveland, Cleveland, OH, USA; School of Medicine, Case Western Reserve University, Cleveland, OH, USA. Electronic address: Kenneth.remy@uhhospitals.org.

Abstract

The SARS-CoV-2 virus has complex and divergent immune alterations in differing hosts and over disease evolution. Much of the nuanced COVID-19 disease immune dysregulation was originally dominated by innate cytokine changes, which has since been replaced with a more complex picture of innate and adaptive changes characterized by simultaneous hyperinflammatory and immunosuppressive phenomena in effector cells. These intricacies are summarized in this review as well as potential relevance from acute infection to a multisystem inflammatory syndrome commonly seen in children. Additional consideration is made for the influence of variant to variant host cellular changes and the impact of potential vaccination upon these phenotypes. Finally, therapeutic benefit for immune alterations are discussed.

Keywords: Adaptive; COVID-19; Host immune response; Immunology; Innate; SARS-CoV-2.

Publication types

Review

MeSH terms

COVID-19*
Cytokines
Humans
Immunity, Innate
SARS-CoV-2

Substances

Cytokines

Supplementary concepts

pediatric multisystem inflammatory disease, COVID-19 related