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Review
. 2022 Sep;35(3):101401.
doi: 10.1016/j.beha.2022.101401. Epub 2022 Oct 15.

COVID-19 disease and immune dysregulation

Ethan Davitt  1 , Colin Davitt  2 , Monty B Mazer  3 , Sathya S Areti  4 , Richard S Hotchkiss  5 , Kenneth E Remy  6
Affiliations
Review

COVID-19 disease and immune dysregulation

Ethan Davitt et al. Best Pract Res Clin Haematol. 2022 Sep.

Abstract

The SARS-CoV-2 virus has complex and divergent immune alterations in differing hosts and over disease evolution. Much of the nuanced COVID-19 disease immune dysregulation was originally dominated by innate cytokine changes, which has since been replaced with a more complex picture of innate and adaptive changes characterized by simultaneous hyperinflammatory and immunosuppressive phenomena in effector cells. These intricacies are summarized in this review as well as potential relevance from acute infection to a multisystem inflammatory syndrome commonly seen in children. Additional consideration is made for the influence of variant to variant host cellular changes and the impact of potential vaccination upon these phenotypes. Finally, therapeutic benefit for immune alterations are discussed.

Keywords: Adaptive; COVID-19; Host immune response; Immunology; Innate; SARS-CoV-2.

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Conflict of interest statement

Declaration of competing interest There are no conflicts to report. Dr. Remy is funded by the National Institutes of Health, National Institute of General Medical Sciences7K08GM129763. Dr. Hotchkiss is funded by the NIH, NIGMS5R35GM126928 and 5R01GM139046.

Figures

Fig. 1
Fig. 1
Proposed pathways for inflammation and immune suppression in COVID-19 immune dysregulation.
See this image and copyright information in PMC

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Supplementary concepts