Immune reactivity during COVID-19: Implications for treatment

Napoli, Claudio; Benincasa, Giuditta; Criscuolo, Clelia; Faenza, Mario; Liberato, Cinzia; Rusciano, Mariangela

doi:10.1016/j.imlet.2021.01.001

Cited by 48 publications

(44 citation statements)

References 67 publications

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“…SARS-CoV-2 enters the cell via the angiotensin-converting enzyme type 2 (ACE-2) receptors, which mainly expressed on pulmonary epithelial cells, but also on lymphocytes and other cell types. The spread of the virus among cells triggers both innate and adaptive immune responses, which then causes the production of large amounts of pro-inflammatory cytokines and chemokines ( 2 , 3 ). In some patients, the activation is massive and develops into a “cytokine storm,” which induces severe inflammatory responses and causing tissue damage or even death ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Immune Response to COVID-19 During Pregnancy

Chen

Liao

et al. 2021

Front. Immunol.

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Pregnant women are generally more susceptible to viral infection. Although the impact of SARS-CoV-2 on pregnant women remains to be determined, evidence indicates that risks of adverse clinical outcomes are similar in pregnancy to the general population. Here we analyzed clinical symptoms and outcomes of 20 pregnant and 299 reproductive-aged non-pregnant female COVID-19 patients who were hospitalized during the same period. Laboratory measurements were compared among mild cases and healthy pregnant women. Our study found that pregnant patients showed enhanced innate immune response evident by higher neutrophils and C-reactive protein. Cytokines, chemokines, and growth factors (CCGFs) profiles from 11 pregnant and 4 non-pregnant COVID-19 patients and 10 healthy pregnant female patients, and lymphocyte subsets analysis of 7 pregnant patients and 19 non-pregnant patients, indicate suppressed cytokine storm and potential enhanced CD8+ T cell and NK cell activity in pregnant patients with COVID-19, which may be essential in contributing to the unique anti-SARS-CoV-2 response in pregnancy.

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Section: Introductionmentioning

confidence: 99%

Immune Response to COVID-19 During Pregnancy

Chen

Liao

et al. 2021

Front. Immunol.

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“…Researches have also revealed that cytokine storm, particularly macrophage activation syndrome (MAS), is the most important complication in COVID-19 infection [129]. MAS results in high expression of inflammatory cytokines such as TNF-α and IL-6 and subsequently these mediators promote inflammatory pathways [130].…”

Section: Monocyte/macrophagementioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2: The Role of the Main Components of the Innate Immune System

et al. 2021

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At the end of December 2019, the COVID-19 pandemic began in Wuhan of China. COVID-19 affects different people with a wide spectrum of clinical manifestations, ranging from asymptomatic with recovery without hospitalization up to a severe acute respiratory syndrome (SARS). The innate and adaptive immunity appears responsible for the defense against the virus and recovery from the disease. The innate immune system, as the first line of defense, is essential for the detection of virus and subsequent activation of acquired immunity. The innate immune response is carried out by sentinel cells such as monocytes/macrophages and dendritic cells and by receptors known as pattern recognition receptors (PRR). These receptors can recognize various components of the virus, which lead to intracellular signaling and subsequently the synthesis of various cytokines. These cytokines then recruit other immune cells, activate adaptive immune responses, and inhibit viral spreading. The most common receptors include Toll-like receptors, C-type lectin receptors, and RIG-I like receptors. This review describes the current knowledge about the interplay between innate immune responses and SARS-CoV-2 with a focus on the innate immune cells and the role of their receptors in viral RNA recognition, as well as their mechanisms for recognizing SARS-CoV-2.

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“…There are also recent data suggesting that PCT (>0.5 μg/L) could be an important prognostic indicator for hyperinflammation and the cytokine storm typically seen in severe COVID-19 progression [ 99 ]. Identification of patients at risk for disease progression may help to initiate anti-inflammatory medication early, thus reducing viral load and avoiding hyperactivation of the immune system [ 99 ]. In addition, a small Turkish study found higher PCT levels in severe COVID-19 patients with disseminated intravascular coagulation (DIC) [ 100 ].…”

Section: Medical Wardmentioning

confidence: 99%

Procalcitonin for individualizing antibiotic treatment: an update with a focus on COVID-19

Wolfisberg

Gregoriano

Schuetz

2021

Critical Reviews in Clinical Laboratory Sciences

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Procalcitonin (PCT) is useful for differentiating between viral and bacterial infections and for reducing the unnecessary use of antibiotics. As the rise of antimicrobial resistance reaches “alarming” levels according to the World Health Organization, the importance of using biomarkers, such as PCT to limit unnecessary antibiotic exposure has further increased. Randomized trials in patients with respiratory tract infections have shown that PCT has prognostic implications and its use, embedded in stewardship protocols, leads to reductions in the use of antibiotics in different clinical settings without compromising clinical outcomes. However, available data are heterogeneous and recent trials found no significant benefit. Still, from these trials, we have learned several key considerations for the optimal use of PCT, which depend on the clinical setting, severity of presentation, and pretest probability for bacterial infection. For patients with respiratory infections and sepsis, PCT can be used to determine whether to initiate antimicrobial therapy in low-risk settings and, together with clinical data, whether to discontinue antimicrobial therapy in certain high-risk settings. There is also increasing evidence regarding PCT-guided therapy in patients with coronavirus disease 2019 (COVID-19). This review provides an up-to-date overview of the use of PCT in different clinical settings and diseases, including a discussion about its potential to improve the care of patients with COVID-19.

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Immune reactivity during COVID-19: Implications for treatment

Cited by 48 publications

References 67 publications

Immune Response to COVID-19 During Pregnancy

Immune Response to COVID-19 During Pregnancy

Severe Acute Respiratory Syndrome Coronavirus 2: The Role of the Main Components of the Innate Immune System

Procalcitonin for individualizing antibiotic treatment: an update with a focus on COVID-19

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