SARS-CoV-2 infection in the immunodeficient host: necessary and dispensable immune pathways

Giardino, Giuliana; Romano, Roberta; Coppola, Emma; Cillo, Francesca; Borzachiello, Carla; De Luca, Martina; Palamaro, Loredana; Toriell, Elisabetta; Prencipe, Rosaria; Cirillo, Emilia; Pignata, Claudio

Since its outbreak in late December 2019 in Wuhan, COVID-19 pandemic has posed a therapeutic challenge for the world population, with a plenty of clinical pictures and a broad spectrum of severity of the manifestations. In spite of initial speculations on a direct role of primary or acquired immune deficiency in determining a worse disease outcome, recent studies have provided evidence that specific immune defects may either serve as an experimentum naturae entailing this risk or may not be relevant enough to impact the host defense against the virus. Taken together, these observations may help unveil pathogenetic mechanisms of the infection and suggest new therapeutic strategies. Thus, in this review we summarize current knowledge regarding the mechanisms of immune response against SARS-CoV-2 infection and clinical manifestations with a special focus on children and patients presenting with congenital or acquired immune deficiency.