Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
J Neuroimmunol. 2021 Jul 15;356:577578. doi: 10.1016/j.jneuroim.2021.577578. Epub 2021 Apr 16.
The emergence of the novel coronavirus (SARS-CoV-2) and the worldwide spread of the coronavirus disease (COVID-19) have led to social regulations that caused substantial changes in manners of daily life. The subsequent loneliness and concerns of the pandemic during social distancing, quarantine, and lockdown are psychosocial stressors that negatively affect the immune system. These effects occur through mechanisms controlled by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenocortical (HPA) axis that alter immune regulation, namely the conserved transcriptional response to adversity (CTRA), which promotes inflammation and diminishes antiviral responses, leading to inadequate protection against viral disease. Unhealthy eating habits, physical inactivity, sleep disturbances, and mental health consequences of COVID-19 add on to the pathological effects of loneliness, making immunity against this ferocious virus an even tougher fight. Therefore, social isolation, with its unintended consequences, has inherently paradoxical effects on immunity in relation to viral disease. Though this paradox can present a challenge, its acknowledgment can serve as an opportunity to address the associated issues and find ways to mitigate the adverse effects. In this review, we aim to explore, in detail, the pathological effects of the new social norms on immunity and present suggested methods to improve our physical, psychological, and healthcare abilities to fight viral infection in the context of the COVID-19 pandemic.
新型冠状病毒（SARS-CoV-2）的出现和冠状病毒病（COVID-19）在全球范围内的传播导致了社会规范的改变，这些改变对日常生活方式产生了重大影响。随后，社交隔离、检疫和封锁期间的孤独感和对大流行的担忧是心理社会应激源，这些应激源通过交感神经系统（SNS）和下丘脑-垂体-肾上腺皮质（HPA）轴控制的机制对免疫系统产生负面影响，这些机制改变了免疫调节，即逆境的保守转录反应（CTRA），促进炎症并减弱抗病毒反应，导致对病毒性疾病的保护不足。COVID-19 导致的不健康饮食习惯、缺乏身体活动、睡眠障碍和心理健康后果加剧了孤独的病理效应，使人体对这种凶猛病毒的免疫力更难发挥作用。因此，社交隔离及其意想不到的后果对与病毒性疾病相关的免疫具有内在的矛盾影响。尽管这种悖论带来了挑战，但认识到这一点可以为解决相关问题提供机会，并找到减轻不利影响的方法。在这篇综述中，我们旨在详细探讨新的社会规范对免疫的病理影响，并提出改善我们的身体、心理和医疗保健能力的建议，以应对 COVID-19 大流行背景下的病毒感染。
