Acta Scientific Microbiology (ASMI) (ISSN: 2581-3226)

Review Article Volume 3 Issue 9

Immune Response and Pathogenesis of COVID-19 and The Strategies for Developing Target Drugs

Anju Kaushal*

Assistant Professor (Former), Shiva Group of Institutions Bilaspur, HP, India

*Corresponding Author: Anju Kaushal, Assistant Professor (Former), Shiva Group of Institutions Bilaspur, HP, India.

Received: August 03, 2020; Published: August 26, 2020



Current pandemic with COVID-19 disease is caused by a novel coronavirus SARSCoV-2, which started from Dec 2019 and still continues. The infection is mainly started by inhalation of virus contaminated droplets. Immune response is produced by both adaptive and innate immunity. Pathogenic stages of virus in the host are asymptomatic stage, non-severe symptomatic and severe- symptomatic stage. Major- Histocompatibility Antigens/HLA classes regulate the adaptive immune response and pathogenesis. In asymptomatic stage the person is recovered normally. However, the innate immune response is impaired in the severe symptomatic stages with high lymphopenia in natural killer cells, but other macrophages and monocytes increased fighting the virus; hence they establish a hyperinflammatory state. Immunological regular functions are precluded mainly due to impaired immune response, because virus lapse the protective immunity by NK cells while favoring its propagation causing inflammations in lungs and other organs such as kidney, liver, spleen etc., could be fatal in later stages.

ACE-2 receptors on alveolar cells with proteaseTMPRSS2 allow the spike of virus to make them attach to the cells for easy virus entry. Monocytes and Macrophages produce cytokines can create “Cytokine storm”, a hyper inflammation in lungs. Cytokine storm is a current hallmark of SARSCoV-2 pathogenesis, is triggered by releasing cytokines GSCF, IP10, MIP1A, IL-2, IL-7 and TNF to cause breathing problem, ARDS, and lungs failure subsequently with acute cardiac injury.

Evidence based medicines integrate the clinical experience and patient values with the accurate information available to provide best treatment for faster patient recovery.

Keywords: COVID-19; SARSCoV-2; ACE-2; ARDS; Immune Response; Cytokines



  1. Atri D., et al. “COVID-19 for cardiologist: a current review of the virology, clinical epidemiology, cardiac and other clinical manifestations and potential therapeutic strategies”. ACC: Basic to Translational Science (2020).
  2. Bell TJ., et al. “Defective lung function following influenza virus is due to prolonged, reversible hyaluronan synthesis”. Matrix Biology 80 (2018): 14-28.
  3. Bero L., et al. “The SSSPIN study-spin in studies of spin: meta research analysis”. BMJ 367 (2019): 16202.
  4. Casillo GM., et al. “ Could IL-17 represent a therapeutic target for the treatment and/or management of COVID-19 related respiratory syndrome? This paper is dedicated to Sofia Maione born during COVID-19 outbreak”. Pharmacology Research (2020).
  5. Caso F., et al. “Could Sars-coronavirus-2 trigger autoimmune and / or autoinflammatory mechanisms in genetically predisposed subjects?” Autoimmun Review 19.5 (2020): 102524.
  6. Channappanavar R., et al. “IFN-I response timing relative to virus replication determines MERS coronavirus infection outcomes”. Journal of Clinical Investigation 130 (2019): 3625-3693.
  7. Chaussabel D. “Assessment of immune status using blood transcriptomics and potential implications for good health”. Seminar in Immunology 27 (2015): 58-66.
  8. Chen X., et al. “Human monoclonal antibodies block the binding of SARS-CoV-2 spike protein to angiotensin converting enzyme 2 receptor”. Cellular and Molecular Immunology 17 (2020): 647-649.
  9. Choi EK., et al. “Body mass index and 20 specific cancers : re- analysis of dose- response meta-analysis of observational studies”. Annuals in Oncology 29 (2018): 749-757.
  10. Conti P., et al. “Coronavirus COV-19/ SARS -COV-2 affects women less than men: clinical response to viral infection”. Journal of Biological Regulators and Homeostatic Agents 34.2 (2020).
  11. Cossarizza S., et al. “SARS-CoV-2, the virus that cause COVID-19: cytometery and the new challenge for global health”. Cytometry 97 A (2020): 340-343.
  12. Dana Rubin. “Pluristem expands its compassionate Use Program: Treated first COVID-19 patient in US. Under FDA Single Pateint expanded access program”.
  13. De Wit E., et al. “SARS and Mers: recent insights into emerging coronaviruses”. Nature Reviews Microbiology 14 (2016): 523-534.
  14. Dutta M., et al. “Polymorphism of HLA class I and class II alleles in influenza A (H1N1) pdm 09 virus infected population of Assam, Northeast India”. Journal of Medical Virology 90 (2018): 854-860.
  15. Federica Raucci., et al. “Interleukin-17 A (IL-17A), a key molecule of innate and adaptive immunity, and its potential involvement in COVID-19 related thrombotic and vascular mechanisms”. Autoimmunity Reviews 19.7 (2020).
  16. Fu Y., et al. “SARS-CoV-2 mediated inflammatory response: from mechanism to potential therapeutic tools”. Virologica Sinica 35 (2020): 266-271.
  17. Hawkins J., et al. “Black elderberry (Sambucus nigra) supplementation effectively treat upper respiratory symptoms: a meta analysis of randomized controlled clinical trials”. Complementary Therapies in Medicine 42 (2019) 361-365.
  18. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395.10223 (2020): 497-506.
  19. Hoffmann M., et al. “SARS-CoV-2 cell entry depends on ACE-2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor”. Cell 181 (2020): 271-280.
  20. Izet Masic., et al. “Evidence based medicine-new approaches and challenges”. Acta Informatica Medica 16.4 (2008): 219-225.
  21. Kikkert M., et al. “Innate immune evasion by human respiratory RNA viruses”. Journal of Innate Immunity 12 (2020): 4-20.
  22. Leah Shaffer. “15 drugs being tested to treat COVID-19 and how they would work”. Nature (2020).
  23. LI G., et al. “Coronavirus infections and immune responses”. Journal of Medical Virology 92.4 (2020): 424-432.
  24. Locati M., et al. “Diversity, mechanisms and significance of macrophage plasticity”. Annual Review of Pathology 15 (2020): 123-147.
  25. Liao M., et al. “The landscape of lung bronchoalveolar immune cells in COVID-19 revealed by single-cell RNA sequencing”. medRxiv (202).
  26. Maggi E., et al. “COVID-19 Unanswered questions on immune response and pathogenesis”. Journal of Allergy and Clinical Immunology 146 (2020): 18-22.
  27. Mehta P., et al. “COVID-19: consider cytokine storm syndromes and immunosuppression”. Lancet 395 (2020): 1033-1034.
  28. Metcalfe SM. “Mesenchymal stem cells and management of COVID-19 pneumonia”. Medicine in Drug Discovery (2020).
  29. Peter B., et al. “T-cell epitope predictions. T cell epitope predictions”. Annual Reviews in Immunology 38 (2020): 123-145.
  30. Perlman S., et al. “Immunopathogenesis of coronavirus infections: implications for SARS”. Nature Review Immunology 5 (2005): 917-927.
  31. Rothe C., et al. “Transmission of 2019-nCoV infection from an Asymptomatic Contact in Germany”. The New England Journal of Medicine 382 (2020). 
  32. Shi Y., et al. “COVID-19 infection: the perspectives on immune response”. Cell Death and Differentiation 27 (2020): 1451-1454.
  33. Shin HS., et al. “Immune response to middle east respiratory syndrome coronavirus during the acute and convalescent phase of human infection”. Clinical Infectious Diseases 68 (2019): 984-992.
  34. Wang A., et al. “Single nucleus multiomic profiling reveals age-dynamic regulation of host genes associated with SARS-CoV-2 infection”. BiorXiv (2020).
  35. Wang G., et al. “Kynurenic acid, an IDO metabolite, control TSG-6-mediated immunosuppression of human mesenchymal stem cells”. Cell Death and Differentiation 25 (2018): 1209-1223. 
  36. Wang D., et al. “Clinical Characteristics of 138 Hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China”. JAMA (2020). 
  37. Wu Z., et al. “Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 cases from the Chinese Centre for Disease Control and Prevention”. JAMA (2020).
  38. Xu Z., et al. “Pathological findings of COVID-19 associated with acute respiratory distress syndrome”. The Lancet Respiratory Medicine (2020).
  39. Zaineb Akram Dr. “Mesenchymal Stem Cell Infusion for COVID-19 Infection”. National Institute of Blood and Marrow Transplant (NIBMT), Pakistan. NIH.US National Library of Medicine.
  40. Zhau Zhau., et al. “Heightened immune responses in the respiratory tract of COVID-19 patients”. Cell Host and Microbe 32.6 (2020): 883-890.e2
  41. Zhou F., et al. “Clinical course and risk factors for mortality of adult patients with COVID-19 in Wuhan, China: a retrospective cohort study”. Lancet 395 (2020): 1054-1062.


Citation: Anju Kaushal. “Immune Response and Pathogenesis of COVID-19 and The Strategies for Developing Target Drugs". Acta Scientific Microbiology 3.9 (2020): 92-102.


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