Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa 52242, USA; email:
Annu Rev Med. 2022 Jan 27;73:65-80. doi: 10.1146/annurev-med-042220-012417. Epub 2021 Aug 26.
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has resulted in a pandemic that has had widespread effects on human activities. The clinical presentation of severe COVID-19 includes a broad spectrum of clinical disease, most notably acute respiratory distress syndrome, cytokine release syndrome (CRS), multiorgan failure, and death. Direct viral damage and uncontrolled inflammation have been suggested as contributory factors in COVID-19 disease severity. The COVID-19 pandemic has emphasized the critical role of an effective host immune response in controlling a virus infection and demonstrated the devastating effect of immune dysregulation. Understanding the nature of the immune response to SARS-CoV-2 pathogenesis is key to developing effective treatments for COVID-19. Here, we describe the nature of the dysregulated host immune response in COVID-19, identify potential mechanisms involved in CRS, and discuss potential strategies that can be used to manage immune dysregulation in COVID-19.
感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是导致 2019 年冠状病毒病（COVID-19）的原因，已导致对人类活动产生广泛影响的大流行。严重 COVID-19 的临床特征包括广泛的临床疾病，最显著的是急性呼吸窘迫综合征、细胞因子释放综合征（CRS）、多器官衰竭和死亡。直接的病毒损伤和失控的炎症被认为是 COVID-19 疾病严重程度的促成因素。COVID-19 大流行强调了有效的宿主免疫反应在控制病毒感染中的关键作用，并展示了免疫失调的破坏性影响。了解宿主对 SARS-CoV-2 发病机制的免疫反应的性质是开发 COVID-19 有效治疗方法的关键。在这里，我们描述了 COVID-19 中失调的宿主免疫反应的性质，确定了 CRS 中涉及的潜在机制，并讨论了可用于管理 COVID-19 中免疫失调的潜在策略。
