Comparison of the Characteristics of Cytokine Storm and Immune Response Induced by SARS-CoV, MERS-CoV, and SARS-CoV-2 Infections

Abstract

Cytokine storm (CS) is a significant cause of death in patients with severe coronavirus pneumonia. Excessive immune-inflammatory reaction, many inflammatory cell infiltration, and extreme increase of proinflammatory cytokines and chemokines lead to acute lung injury and acute respiratory distress syndrome (ARDS). This review compares the characters of cytokine storms and immune responses caused by three highly pathogenic and infectious coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome-coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and analyzes the possible mechanisms to guide clinical treatment in the future.

Keywords: coronavirus pneumonia; cytokine storm; cytokines; immune evasion; interferon.

Figure 1

The infection and replication of SARS-CoV in epithelial cells and immune cells. SARS-CoV infect and replicate in epithelial cells. Monocyte-macrophage and DCs are infected by SARS-CoV to induced apoptosis of activated T cells. The cells in the dotted frame can secrete a variety of cytokines in the immune response, further forming a cytokine storm.

Figure 2

MERS-CoV can infect and replicate in the cells shown above, causing apoptosis in the dotted frame and releasing cytokines that cause cytokine storms. It is worth noting that whether it can replicate in human monocyte-derived macrophages and DCs is still not clear.

Figure 3

SARS-CoV-2 infect and replicate in epithelial cells and T cells and cause them to secrete a large number of cytokines, which can cause cytokine storms to cause the damage of heart, kidney and lungs. But it is not clear which other cells that SARS-CoV-2 can infect and replicate in them.