Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, CEP, 31270-901, Belo Horizonte, MG, Brazil.
Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, CEP, 31270-901, Belo Horizonte, MG, Brazil; Biomarkers Research Group, Instituto René Rachou, Osvaldo Cruz Foundation - FIOCRUZ-MINAS, Belo Horizonte, Minas Gerais, Brazil.
Immunol Lett. 2021 Jul;235:9-14. doi: 10.1016/j.imlet.2021.04.005. Epub 2021 Apr 24.
An alarming disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) named COVID-19 has emerged as an unprecedented public health problem and ignited a world health crisis. As opposed to what was believed at the beginning of the pandemic, the virus has not only spread but persevere causing secondary waves and challenging the concept of herd immunity against viral infections. While the majority of SARS-CoV-2-infected individuals may remain asymptomatic, a fraction of individuals may develop low to high-grade severity signs and symptoms of COVID-19. The disease is multifactorial and can progress quickly, leading to severe complications and even death in a few days. Therefore, understanding the pre-existing factors for disease development has never been so pressing. In this scenario, the insights on the mechanisms underlying disease allied to the immune response developed during the viral invasion could shed light on novel predictive factors and prognostic tools for COVID-19 management and interventions. A recent genome-wide association study (GWAS) revealed several molecules that significantly impacted critically ill COVID-19 patients, leading to the core mechanisms of COVID-19 pathogenesis. Considering these findings and the fact that ACE-2 polymorphisms alone cannot explain disease progress and severity, this review aims at summarizing the most important and recent findings of the research and expert consensus of possible cytokine-related polymorphisms existing in the differential expression of paramount immune molecules that could be crucial for providing guidelines for decision-making and appropriate clinical management of COVID-19.
一种由新型严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的令人震惊的疾病 COVID-19 已经成为一个前所未有的公共卫生问题，并引发了一场世界卫生危机。与大流行初期的看法相反，该病毒不仅传播，而且坚持造成二次波，挑战了针对病毒感染的群体免疫概念。虽然大多数 SARS-CoV-2 感染个体可能保持无症状，但一部分个体可能会出现低至高度严重程度的 COVID-19 症状和体征。这种疾病是多因素的，可能会迅速发展，导致严重的并发症，甚至在几天内死亡。因此，了解疾病发展的潜在因素从未如此紧迫。在这种情况下，对病毒入侵期间发生的疾病相关机制和免疫反应的深入了解，可以为 COVID-19 的管理和干预提供新的预测因素和预后工具。最近的全基因组关联研究（GWAS）揭示了一些对重症 COVID-19 患者有重大影响的分子，这些分子导致了 COVID-19 发病机制的核心机制。考虑到这些发现以及 ACE-2 多态性本身不能解释疾病的进展和严重程度，本综述旨在总结研究中最重要和最新的发现，以及专家共识，即存在可能与细胞因子相关的多态性，这些多态性可能存在于重要免疫分子的差异表达中，这对于为 COVID-19 的决策和适当临床管理提供指导方针可能至关重要。
