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Review
. 2021 Apr 30:12:646333.
doi: 10.3389/fimmu.2021.646333. eCollection 2021.

Cellular Immune Response to COVID-19 and Potential Immune Modulators

Xi Zhou  1 , Qing Ye  1
Affiliations
Review

Cellular Immune Response to COVID-19 and Potential Immune Modulators

Xi Zhou et al. Front Immunol. .

Abstract

Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Droplets and contacts serve as the main route of transmission of SARS-CoV-2. The characteristic of the disease is rather heterogeneous, ranging from no symptoms to critical illness. The factors associated with the outcome of COVID-19 have not been completely characterized to date. Inspired by previous studies on the relevance of infectious diseases, viral and host factors related to clinical outcomes have been identified. The severity of COVID-19 is mainly related to host factors, especially cellular immune responses in patients. Patients with mild COVID-19 and improved patients with severe COVID-19 exhibit a normal immune response to effectively eliminate the virus. The immune response in patients with fatal severe COVID-19 includes three stages: normal or hypofunction, hyperactivation, and anergy. Eventually, the patients were unable to resist viral infection and died. Based on our understanding of the kinetics of immune responses during COVID-19, we suggest that type I interferon (IFN) could be administered to patients with severe COVID-19 in the hypofunctional stage, intravenous immunoglobulin (IVIG) and glucocorticoid therapy could be administered in the immune hyperactivation stage. In addition, low molecular weight heparin (LMWH) anticoagulation therapy and anti-infective therapy with antibiotics are recommended in the hyperactivation stage.

Keywords: COVID-19; SARS-COV-2; cellular immune response; clinical outcome; potential immune modulators.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Cellular immune responses to SARS-CoV-2. The simulated diagram shows the kinetics of immune responses in COVID-19 patients with different clinical outcomes and the treatment in different stages. (↑ or ↓ means that compared with the result in the early stage, the number or activation of immune cells in described stage is increased or decreased) NK, nature killer cell; M, monocyte; N, neutrophil; DC, dendritic cell.
See this image and copyright information in PMC

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