Immunology, Immunopathogenesis and Immunotherapeutics of COVID-19; an Overview

Mohamed Khosroshahi, Leila; Rokni, Mohsen; Mokhtari, Tahmineh; Noorbakhsh, Farshid

Coronavirus disease 2019 (COVID-19) infection which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a “public health emergency of international concern” (PHEIC). The infection is highly contagious, has a high mortality rate, and its pathophysiology remains poorly understood. Pulmonary inflammations with substantial lung damage together with generalized immune dysregulation are major components of COVID-19 pathogenesis. Of these two components, lung damage seems to be, at least in part, a consequence of immune dysregulation. This study revealed that these immune alterations are not merely an association, as it might occur in systemic infection, but, very likely, the core pathogenic element of COVID-19. In addition, management of the immune responses to SARS-CoV-2, which includes enhancing anti-viral immunity while inhibiting systemic inflammation, may be key to successful treatment. Herein, we have reviewed current evidence related to different aspects of COVID-19 immunology, including innate and adaptive immune responses against the virus and mechanisms of virus-induced immune dysregulation. Considering that an effective vaccine is not yet available to the public and current antiviral therapies are chiefly experimental, strategies do immunotherapy for the management of disease have also been reviewed. Understanding the immune dysregulation in COVID-19 is important to develop more effective immunotherapeutics, diagnostic, and prophylactic strategies in this disease.