The Role of Innate Immunity in COVID-19
Article Sidebar
Main Article Content
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
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors maintain copyright and grant the Health Sciences Journal the right to first publication. From 2024, the publications wiil be licensed under Attribution 4.0 International 
, allowing their sharing, recognizing the authorship and initial publication in this journal.
Authors are authorized to assume additional contracts separately for the non-exclusive distribution of the version of the work published in this journal (e.g., publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
Authors are encouraged to publish and distribute their work online (e.g., in institutional repositories or on their personal page) at any point after the editorial process.
Also, the AUTHOR is informed and consents that the Health Sciences Journal can incorporate his article into existing or future scientific databases and indexers, under the conditions defined by the latter at all times, which will involve, at least, the possibility that the holders of these databases can perform the following actions on the article.
References
2. 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
3. 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
4. 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
5. Hindson J. COVID-19: faecal–oral transmission?. Nat Rev Gastroenterol Hepatol. 2020;17(5):259. doi: 10.1038/s41575-020-0295-7
6. 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
7. 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
8. 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
9. 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
10. 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
11. 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
12. 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
13. 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
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
20. 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
21. 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
22. 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
23. 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
24. 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
25. 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
26. 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
27. 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
28. 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
29. 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
30. 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