Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Oct 30:11:589474.
doi: 10.3389/fimmu.2020.589474. eCollection 2020.

COVID-19 and Systemic Lupus Erythematosus: Focus on Immune Response and Therapeutics

Allison P Spihlman  1   2 , Nirupa Gadi  1   2 , Samantha C Wu  1   2 , Vaishali R Moulton  1
Affiliations
Review

COVID-19 and Systemic Lupus Erythematosus: Focus on Immune Response and Therapeutics

Allison P Spihlman et al. Front Immunol. .

Abstract

The SARS-CoV-2 novel coronavirus has caused the COVID-19 pandemic with over 35 million cases and over a million deaths worldwide as of early October 2020. The populations most affected are the elderly and especially those with underlying comorbidities. In terms of race and ethnicity, black and hispanic populations are affected at disproportionately higher rates. Individuals with underlying conditions that cause an immune-compromised state are considered vulnerable to this infection. The immune response is an important determinant in viral infections including coronaviruses, not only in the antiviral defense but also in the disease progression, severity, and clinical outcomes of COVID-19. Systemic lupus erythematosus is a chronic autoimmune disease which also disproportionately afflicts black and hispanic populations. In lupus patients, an aberrant immune response is characterized by the presence of circulating autoantibodies, lymphopenia, aberrant T cells, and proinflammatory cytokines along with defective regulatory mechanisms, leading to immune-mediated damage to tissues. Lupus patients are often treated with immune-suppressants and therefore are immune-compromised and more susceptible to infections and may be vulnerable to coronavirus infection. While the anti-viral immune response is important to protect from coronavirus infection, an uncontrolled proinflammatory cytokine response can lead to cytokine storm which causes damage to the lungs and other organs, causing significant morbidity and mortality. Better understanding of the underlying immune response and therapeutic strategies in lupus and COVID-19 is important to guide management of this deadly infectious disease in the context of lupus and vice-versa.

Keywords: COVID-19; coronavirus infection; immune response; systemic lupus erythematosus; therapeutics.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Venn diagram displaying the differences and similarities between incidence, clinical findings, and immune responses in systemic lupus erythematosus and COVID-19.
Figure 2
Figure 2
Schematic representation of appropriate and dysregulated host immune responses to coronavirus infection and the consequences of each.
See this image and copyright information in PMC

References

    1. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New Engl J Med (2020) 382:1708–20. 10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Walls AC, Park Y-J, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein. Cell (2020) 181:281–92. 10.1016/j.cell.2020.02.058 - DOI - PMC - PubMed
    1. García LF. Immune Response, Inflammation, and the Clinical Spectrum of COVID-19. Front Immunol (2020) 11:1–3. 10.3389/fimmu.2020.01441 - DOI - PMC - PubMed
    1. Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M, et al. Immune-Inflammatory Parameters in COVID-19 Cases: A Systematic Review and Meta-Analysis. Front Med (2020) 7:1–14. 10.3389/fmed.2020.00301 - DOI - PMC - PubMed
    1. Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol (2020) 20:363–74. 10.1038/s41577-020-0311-8 - DOI - PMC - PubMed

Publication types