Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States.
Front Immunol. 2020 Sep 29;11:569611. doi: 10.3389/fimmu.2020.569611. eCollection 2020.
COVID-19 caused by SARS CoV2 emerged in China at the end of 2019 and soon become a pandemic. Since the virus is novel, pre-existing CoV2-specific immunity is not expected to exist in humans, although studies have shown presence of CoV2 cross-reactive T cells in unexposed individuals. Lack of effective immunity in most individuals along with high infectiousness of the virus has resulted in massive global public health emergency. Intense efforts are on to study viral pathogenesis and immune response to help guide prophylactic and therapeutic interventions as well as epidemiological assessments like transmission modeling. To develop an effective vaccine or biologic therapeutic, it is critical to understand the immune correlates of COVID-19 control. At the same time, whether immunity in recovered individuals is effective for preventing re-infection will be important for informing interventions like social distancing. Key questions that are being investigated regarding immune response in COVID-19 which will help these efforts include, investigations of immune response that distinguishes patients with severe versus mild infection or those that recover relative to those that succumb, durability of immunity in recovered patients and relevance of developed immunity in a cured patient for protection against re-infection as well as value of convalescent plasma from recovered patients as a potential therapeutic modality. This is a broad and rapidly evolving area and multiple reports on status of innate and adaptive immunity against SARS-CoV2 are emerging on a daily basis. While many questions remain unanswered for now, the purpose of this focused review is to summarize the current understanding regarding immune correlates of COVID-19 severity and resolution in order to assist researchers in the field to pursue new directions in prevention and control.
由 SARS CoV2 引起的 COVID-19 于 2019 年底在中国出现,很快就成为了一种大流行疾病。由于该病毒是新型的,预计人类体内不会存在针对 CoV2 的预先存在的特异性免疫,尽管研究表明未接触过该病毒的个体中存在 CoV2 交叉反应性 T 细胞。由于大多数人缺乏有效的免疫力,加上该病毒具有高度传染性,导致了大规模的全球公共卫生紧急事件。目前正在进行大量研究,以了解病毒的发病机制和免疫反应,以帮助指导预防和治疗干预措施,以及进行像传播建模这样的流行病学评估。为了开发有效的疫苗或生物治疗药物,了解 COVID-19 控制的免疫相关性至关重要。同时,对于像社交隔离这样的干预措施,了解已康复个体的免疫力是否对预防再次感染有效也很重要。正在研究 COVID-19 免疫反应的关键问题包括:区分严重感染与轻度感染或康复患者与死亡患者的免疫反应;康复患者的免疫持久性;已康复患者产生的免疫对预防再次感染的相关性;以及从康复患者中获取的恢复期血浆作为一种潜在治疗方法的价值。这是一个广泛且快速发展的领域,每天都有大量关于针对 SARS-CoV2 的先天和适应性免疫的报告出现。虽然目前仍有许多问题尚未得到解答,但本综述的目的是总结目前对 COVID-19 严重程度和康复的免疫相关性的理解,以帮助该领域的研究人员在预防和控制方面寻求新的方向。
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