A hypothesis on the role of the human immune system in covid-19

Khashkhosha, Hind Khairi; Elhadi, Muhammed

doi:10.1016/j.mehy.2020.110066

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…145 It has also been suggested that mucus hypersecretion is an underlying cause of hypoxia in COVID-19 patients. 146 Interestingly, PM exposure can suppress mucociliary clearance and promotes mucus hypersecretion, 147,148 although whether effects of PM exposure on mucus production and mucociliary clearance affect SARS-CoV-2 infection and COVID-19 pathogenesis is unclear. Pollutant exposure also decreases levels of various antioxidants in the respiratory tract-lining fluid and tissues, increasing the susceptibility to further oxidative damage mediated by inflammation and/or continued pollutant exposure.…”

Section: How Can Air Pollution Contribute To Sars-cov-2 Infection Andmentioning

confidence: 99%

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

Woodby

Arnold

Valacchi

2020

Annals of the New York Academy of Sciences

127

113

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Exposure to air pollutants has been previously associated with respiratory viral infections, including influenza, measles, mumps, rhinovirus, and respiratory syncytial virus. Epidemiological studies have also suggested that air pollution exposure is associated with increased cases of SARS-CoV-2 infection and COVID-19-associated mortality, although the molecular mechanisms by which pollutant exposure affects viral infection and pathogenesis of COVID-19 remain unknown. In this review, we suggest potential molecular mechanisms that could account for this association. We have focused on the potential effect of exposure to nitrogen dioxide (NO 2), ozone (O 3), and particulate matter (PM) since there are studies investigating how exposure to these pollutants affects the life cycle of other viruses. We have concluded that pollutant exposure may affect different stages of the viral life cycle, including inhibition of mucociliary clearance, alteration of viral receptors and proteases required for entry, changes to antiviral interferon production and viral replication, changes in viral assembly mediated by autophagy, prevention of uptake by macrophages, and promotion of viral spread by increasing epithelial permeability. We believe that exposure to pollutants skews adaptive immune responses toward bacterial/allergic immune responses, as opposed to antiviral responses. Exposure to air pollutants could also predispose exposed populations toward developing COIVD-19associated immunopathology, enhancing virus-induced tissue inflammation and damage.

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Section: How Can Air Pollution Contribute To Sars-cov-2 Infection Andmentioning

confidence: 99%

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

Woodby

Arnold

Valacchi

2020

Annals of the New York Academy of Sciences

127

113

View full text Add to dashboard Cite

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“…Numerous studies conclude that the recent coronavirus infection causes an allergic reaction in respiratory tract mucosa, which activates mucin secretion and modulates its chemical structure to enable the virus to enter the cells. [1][2][3] Thereafter, SARS-CoV-2 initiates neutrophil and mucus-mediated inflammatory pathways. 4 SARS-CoV-2 is shed predominantly in upper and lower airway tract secretions.…”

Section: Introductionmentioning

confidence: 99%

Cytokine Storm and Mucus Hypersecretion in COVID-19: Review of Mechanisms

Khan¹,

Khan²,

Munier³

et al. 2021

JIR

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Mucus is an integral part of the respiratory physiology. It protects the respiratory tract by acting as a physical barrier against inhaled particles and microbes. Excessive inflammation in conditions such as COVID-19 can result in over-production of mucus which obstructs the airway. Build-up of mucus can also contribute to recurrent airway infection, causing further obstruction. This article summarizes the current understanding and knowledge of respiratory mucus production and proposes the role of cytokine storm in inducing sudden mucus hypersecretion in COVID-19. Based on these cascades, the active constituents that inhibit or activate several potential targets are outlined for further research. These may be explored for the discovery and design of drugs to combat cytokine storm and its ensuing complications.

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“…SARS-Cov-2 hyperstimulate respiratory mucosa through type I hypersensitivity which trigger inflammatory biomarkers. [15] Inflammation triggers neutrophil chemotaxis. Lung-infiltrating neutrophils produce neutrophil extracellular traps (NETs) which increase mucus accumulation and rigidity.…”

Section: Discussionmentioning

confidence: 99%

“…[18] Mucus hypersecretion causes mucus plug formation. [15] Mucous plug can partially or completely obstruct one or more airways, hence should be considered as one of the significant problem in COVID-19 patient as it may worsen shunting and cause desaturation due to further atelectasis and providing suitable environmen bacterial superinfection. [19] Thus bronchoscopy can be considered as therapeutic measures in patients with significant mucous plug formation which is evidenced by infiltrate and/or atelectasis in CXR.…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopy Manifestation In Severe COVID-19 Patient: Case Series 

Widysanto¹,

Sutanto²,

Soetjipto³

et al. 2020

Preprint

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Background: Severe manifestation of COVID-19 are identical with significant inflammation and associated with high mortality due to severe hypoxemia. Bronchoscopy’s role in the management of COVID-19 patients is still controversial and minimally evaluatedCase presentation: Our case series reported unique bronchoscopy presentation. Three patients with COVID-19 were confirmed by PCR nasophryngeal swab suddenly complain of progressive dyspnea and impending respiratory failure not respond with oxygen therapy. An emergency bronchoscopy was performed. All three patient had a normal bronchial wall without inflammation and edema but showed significant thick and copious mucus plug resulting in sudden desaturation. Patient showed significant clinical improvement following bronchoscopy intervention showed by clinical and chest x-ray improvement. Conclusion : Deteriorating severe COVID-19 patient can have normal bronchial mucosa in bronchoscopy and showed marked thick and copious mucus plug. Bronchial washing and suction can be a life-saving modality as therapeutic effort. Significant improvements following the bronchial washing and suction was seen. Bronchoscopy should be performed with precaution and sufficient personal protective equipment to prevent infection transmission.

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A hypothesis on the role of the human immune system in covid-19

Cited by 11 publications

References 29 publications

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

Cytokine Storm and Mucus Hypersecretion in COVID-19: Review of Mechanisms

Bronchoscopy Manifestation In Severe COVID-19 Patient: Case Series

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A hypothesis on the role of the human immune system in covid-19

Cited by 11 publications

References 29 publications

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

SARS‐CoV‐2 infection, COVID‐19 pathogenesis, and exposure to air pollution: What is the connection?

Cytokine Storm and Mucus Hypersecretion in COVID-19: Review of Mechanisms

Bronchoscopy Manifestation In Severe COVID-19 Patient: Case Series&nbsp;

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Bronchoscopy Manifestation In Severe COVID-19 Patient: Case Series