The immune system as a target for therapy of SARS-CoV-2: A systematic review of the current immunotherapies for COVID-19

Abstract

Aims The immune response is essential for the control and resolution of viral infections. Following the outbreak of novel coronavirus disease (COVID-19), several immunotherapies were applied to modulate the immune responses of the affected patients. In this review, we aimed to describe the role of the immune system in response to COVID-19. We also provide a systematic review to collate and describe all published reports of the using immunotherapies, including convalescent plasma therapy, monoclonal antibodies, cytokine therapy, mesenchymal stem cell therapy, and intravenous immunoglobulin and their important outcomes in COVID-19 patients. Material and methods A thorough search strategy was applied to identify published research trials in PubMed, Scopus, Medline, and EMBASE from Dec 1, 2019, to May 4, 2020, for studies reporting clinical outcomes of COVID-19 patients treated with immunotherapies along with other standard cares. Key findings From an initial screen of 80 identified studies, 24 studies provided clinical outcome data on the use of immunotherapies for the treatment of COVID-19 patients, including convalescent plasma therapy (33 patients), monoclonal antibodies (55 patients), interferon (31 patients), mesenchymal stem cell therapy (8 patient), and immunoglobulin (63 patients). Except for nine severe patients who died after treatment, most patients were recovered from COVID-19 with improved clinical symptoms and laboratory assessment. Significance Based on the available evidence, it seems that treatment with immunotherapy along with other standard cares could be an effective and safe approach to modulate the immune system and improvement of clinical outcomes.

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

“…While the induction of effective cellular immunity is likely essential for the COVID-19 control, dysregulated T cell activation (by overproduction of IFN associated cytokines promoting retention of lymphocytes in lymphoid organs) may underly main immunopathology and contribute to disease severity in COVID-19 patients [32,[34][35][36]. Although the exposure to pathogens may be lower in PID patients due to more strict self-isolation, it should be noted that the majority of PID cases require to visit the hospital and medical centers regularly which may predispose them even more to exposure to different pathogens as well as COVID-19.…”

SARS-CoV-2 therapeutics: how far do we stand from a remedy?

“…Furthermore, other immunotherapies using monoclonal antibodies, cytokines, interferon, and mesenchymal stem cell therapy are also under clinical trials in an effort to modulate immune response in COVID-19 patients (reviewed by Mansourabadi and coworkers [ 135 ]).…”

Acute Seizures Occurring in Association With SARS-CoV-2

“…The neuroimaging findings in COVID-19 are extremely heterogenous and may vary based on the severity of infection (37). Immunotherapy, such as corticosteroids, targeted molecular therapies such as monoclonal antibodies, IV immunoglobulins, or convalescent plasma for patients with these manifestations may be potentially beneficial, though more systematic research is required (36,(38)(39)(40). During their course of treatment early on in the New York area pandemic, three patients in our series received methylprednisolone, two received hydroxychloroquine, one received tocilizumab, and one was administered anakinra.…”