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Comment
. 2020 Oct;46(10):1897-1900.
doi: 10.1007/s00134-020-06170-8. Epub 2020 Jul 17.

Pulmonary immune responses against SARS-CoV-2 infection: harmful or not?

A Guillon  1   2   3 , P S Hiemstra  4 , M Si-Tahar  5   6
Affiliations
Comment

Pulmonary immune responses against SARS-CoV-2 infection: harmful or not?

A Guillon et al. Intensive Care Med. 2020 Oct.
No abstract available

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Proposed model of host–pathogen interactions in the lungs of COVID-19 patients. SARS-CoV-2 virus is thought to initially infect the upper airways and reach the periphery of the lungs by microaspiration [1]. In those patients in which the virus has ended up infecting the peripheral lung, the majority of patients will likely clear the virus and have a limited inflammatory response with mild clinical disease (upper panels). However, insufficiently controlled SARS-CoV-2 replication due to suppression of antiviral defenses by the virus as well as to host susceptibility factors subsequently leads to a dysregulated inflammatory response which is probably mostly restricted to the lungs (lower panels). Clinical manifestations of COVID-19 are assumed to be explained by a combination of uncontrolled immune responses and virus-induced direct cytopathic effects (central, upper, and lower panels). Thus, immunotherapies should be considered with caution, if not given at the appropriate step of the disease as on one hand, they may efficiently target the host deleterious inflammatory response, but on the other hand, they may as well promote SARS-CoV-2 virus multiplication by inhibiting the host antiviral immune shield, thereby delaying virus clearance (left, upper, and lower panels)
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