The Role of Innate Immunity in COVID-19

Main Article Content

Luiz Henrique Silva de Sordi
https://orcid.org/0000-0003-3349-6025
Isabela Sales Oliveira Magalhães
https://orcid.org/0000-0001-5200-0414
Daniela Abreu Casselhas
Mariléia Chaves Andrade
https://orcid.org/0000-0002-4496-7331

Abstract

The immune system plays an essential role in the COVID-19 pandemic, as it is involved in the pathogenesis and worsening of the disease. The purpose of this review is to address aspects of innate immunity in COVID-19, especially the role of neutrophils. The innate immune system corresponds to the organism's first defense, but a balance must be effective against the invader without harming the host excessively. An immune imbalance is related to more severe conditions and aberrant neutrophil activation, with lymphopenia and neutrophilia being predictors of a worse prognosis in patients with COVID-19. Neutrophilia is speculated to be an important source for the excessive formation of NET (Neutrophil Extracellular Traps), leading to increased inflammatory response and unfavorable evolution of the disease. NETs are also associated with the cytokine storm, another mechanism related to COVID-19's gravity. Therefore, strategies involving immunomodulation may have an essential role in controlling the disease.



Article Details

How to Cite
1.
Silva de Sordi LH, Magalhães ISO, Casselhas DA, Andrade MC. The Role of Innate Immunity in COVID-19 . HSJ [Internet]. 2020 Jul. 2 [cited 2024 Nov. 4];10(3):5-8. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/997
Section
NARRATIVE REVIEW
Author Biographies

Luiz Henrique Silva de Sordi, Faculdade de Medicina de Itajubá

Acadêmico do 5° ano de Medicina da Faculdade de Medicina de Itajubá, Itajubá, MG, Brasil.

Isabela Sales Oliveira Magalhães, Faculdade de Medicina de Itajubá

Acadêmica do 5° ano de Medicina da Faculdade de Medicina de Itajubá, Itajubá, MG, Brasil; Graduação em Direito pelo Centro Universitário de Lavras, MG, Brasil.

Daniela Abreu Casselhas, Faculdade de Medicina de Itajubá

Acadêmica do 5° ano de Medicina da Faculdade de Medicina de Itajubá, Itajubá, MG, Brasil.

Mariléia Chaves Andrade, Faculdade de Medicina de Itajubá

Professora da Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil; Pós-doutorado pela Universidade de Santiago de Compostela, USC, Espanha.

References

Golonka RM, Saha P, Yeoh BS, Chattopadhyay S, Gewirtz AT, Joe B, et al. Harnessing innate immunity to eliminate SARS-CoV-2 and ameliorate COVID-19 disease. Physiol Genomics. 2020;52(5):217‐21. doi: 10.1152/physiolgenomics.00033.2020

Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11. doi: 10.1186/s40779-020-00240-0

Sun J, He WT, Wang L, Lai A, Ji X, Zhai X, et al. COVID-19: Epidemiology, evolution, and cross-disciplinary perspectives. Trends Mol Med. 2020;26(5):483‐495. doi: 10.1016/j.molmed.2020.02.008

Freitas ARR, Napimoga M, Donalisio MR. Análise da gravidade da pandemia de Covid-19. Epidemiol Serv Saude. 2020;29(2):e2020119. doi: 10.5123/S1679-49742020000200008

Hindson J. COVID-19: faecal–oral transmission?. Nat Rev Gastroenterol Hepatol. 2020;17(5):259. doi: 10.1038/s41575-020-0295-7

Singhal T. A review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281‐6. doi: 10.1007/s12098-020-03263-6

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13. doi: 10.1016/s0140-6736(20)30211-7

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061‐9. doi: 10.1001/jama.2020.1585

Barnes BJ, Adrover JM, Baxter-Stoltzfus A, Borczuk A, Cools-Lartigue J, Crawford JM, et al. Targeting potential drivers of COVID-19: Neutrophil extracellular traps. J Exp Med. 2020;217(6):e20200652. doi: 10.1084/jem.20200652

Wan S, Yi Q, Fan S, Lv J, Zhang X, Guo L et al. Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP). MedRxiv. 2020. 02.10.20021832 [preprint]. doi: 10.1101/2020.02.10.20021832

Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020;ciaa248. doi: 10.1093/cid/ciaa248

Vabret N, Britton G, Gruber C, Hegde S, Kim J, Kuksin M et al. Immunology of COVID-19: current state of the science. Immunity. 2020;52(6):910-41. doi: 10.1016/j.immuni.2020.05.002

Felsenstein S, Herbert JA, McNamara PS, Hedrich CM. COVID-19: Immunology and treatment options. Clin Immunol. 2020;215:108448. doi: 10.1016/j.clim.2020.108448

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020;10(2):102-8. doi: 10.1016/j.jpha.2020.03.001

Zhong J, Tang J, Ye C, Dong L. The immunology of COVID-19: is immune modulation an option for treatment? Lancet Rheumatol. 2020;2(7):E428-36. doi: 10.1016/S2665-9913(20)30120-X

Liew PX, Kubes P. The neutrophil's role during health and disease. Physiol Rev. 2019; 99(2):1223‐48. doi: 10.1152/physrev.00012.2018

Prompetchara E, Ketloy C, Palaga T. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol. 2020;38:1-9. doi: 10.12932/ap-200220-0772

Twaddell SH, Baines KJ, Grainge Christopher, Gibson PG. The emerging role of neutrophil extracellular traps in respiratory disease. Chest. 2019;156(4):774–82. doi: 10.1016/j.chest.2019.06.012

Zuo Y, Yalavarthi S, Shi H, Gockman K, Zuo M, Madison JA et al. Neutrophil extracellular traps in COVID-19. JCI Insight. 2020;5(11):e138999. doi: 10.1172/jci.insight.138999

Mozzini C, Girelli D. The role of neutrophil extracellular traps in Covid-19: Only an hypothesis or a potential new field of research? Thromb Res. 2020;191:26‐27. doi: 10.1016/j.thromres.2020.04.031

Iba T, Levy JH, Raj A, and Warkentin TE. Advance in the management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Clin Med. 2019;8(5):728. doi: 10.3390/jcm8050728

Ward PA, Fattahi F. New strategies for treatment of infectious sepsis. J Leukoc Biol. 2019;106(1):187-92. doi: 10.1002/JLB.4MIR1118-425R

Potey PM, Rossi AG, Lucas CD, Dorward DA. Neutrophils in the initiation and resolution of acute pulmonary inflammation: understanding biological function and therapeutic potential. J Pathol. 2019;247(5):672‐85. doi: 10.1002/path.5221

Thierry A, Roch B. NETs By-products and Extracellular DNA May Play a Key Role in COVID-19 Pathogenesis: Incidence on Patient Monitoring and Therapy. Preprints [preprint]. 2020; 2020040238. doi: 10.20944/preprints202004.0238.v1

Veras FP, Pontelli M, Silva C, Toller-Kawahisa J, Lima M, Nascimento D, et al. SARS-CoV-2 triggered neutrophil extracellular traps (NETs) mediate COVID-19 pathology. MedRxiv [preprint]; 2020.06.08.20125823. doi: 10.1101/2020.06.08.20125823

Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Infect. 2020;80(6):607-13. doi: 10.1016/j.jinf.2020.03.037

Cao X. COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol. 2020;20(5):269‐270. doi: 10.1038/s41577-020-0308-3

Narasaraju T, Tang BM, Herrmann M, Muller S, Chow VTK, Radic M. Neutrophilia and NETopathy as Key Pathologic Drivers of Progressive Lung Impairment in Patients With COVID-19. Front Pharmacol. 2020;11:870. doi: 10.3389/fphar.2020.00870

Catanzaro M, Fagiani F, Racchi M, Corsini E, Govoni S, Lanni C. Immune response in COVID-19: addressing a pharmacological challenge by targeting pathways triggered by SARS-CoV-2. Signal Transduct Target Ther. 2020;5(1):84. doi: 10.1038/s41392-020-0191-1

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