The battle between 2019-nCoV and host immune system: implications for therapy / 中华微生物学和免疫学杂志

ABSTRACT

Currently, there are many reports on the clinical phenotypes and epidemiological data of COVID-19. Understanding the underlying pathogenesis is important for disease management. With the implications from studies on severe acute respiratory syndrome (SARS), this review mainly discussed the pathogenesis of COVID-19 and focused on the host immune response to viruses. Direct damage to tissues and organs and excessive inflammatory responses induced by 2019-nCoV are associated with the pathological process and disease progression. Viral load and high inflammatory response are related to disease severity. Peripheral lymphocytes are closely associated with the acute lung injury, and can be used to predict disease severity. 2019-nCoV-specific antibody and T cell immune response can be detected in patients with 2019-nCoV infection. Given the two sides of inflammation and hormone therapy, steroid as a broad-spectrum immunosuppressant needs to be used with caution. Biologics targeting IL-6 and convalescent plasma therapy are promising treatment for COVID-19. Further research on viral features, pathogenesis, immunopathogenesis and specific immune defense would be conducive to better understanding of COVID-19 and achieving precision medicine.