The novel coronavirus SARS-CoV2 causes COVID-19, a pandemic threatening millions. As protective immunity does not exist in humans and the virus is capable of escaping innate immune responses, it can proliferate, unhindered, in primarily infected tissues. Subsequent cell death results in the release of virus particles and intracellular components to the extracellular space, which result in immune cell recruitment, the generation of immune complexes and associated damage. Infection of monocytes/macrophages and/or recruitment of uninfected immune cells can result in massive inflammatory responses later in the disease. Uncontrolled production of pro-inflammatory mediators contributes to ARDS and cytokine storm syndrome. Antiviral agents and immune modulating treatments are currently being trialled. Understanding immune evasion strategies of SARS-CoV2 and the resulting delayed massive immune response will result in the identification of biomarkers that predict outcomes as well as phenotype and disease stage specific treatments that will likely include both antiviral and immune modulating agents.

中文翻译：

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COVID-19：免疫学和治疗选择。

新型冠状病毒 SARS-CoV2 引发了新冠肺炎 (COVID-19)，这是一种威胁数百万人的大流行病。由于人类不存在保护性免疫，并且病毒能够逃避先天免疫反应，因此它可以在主要感染的组织中不受阻碍地增殖。随后的细胞死亡导致病毒颗粒和细胞内成分释放到细胞外空间，从而导致免疫细胞募集、免疫复合物的产生和相关损伤。单核细胞/巨噬细胞的感染和/或未感染免疫细胞的募集可能会导致疾病后期出现大量炎症反应。促炎介质的不受控制的产生会导致 ARDS 和细胞因子风暴综合征。目前正在试验抗病毒药物和免疫调节治疗。了解 SARS-CoV2 的免疫逃避策略以及由此产生的延迟的大规模免疫反应，将有助于识别预测结果以及表型和疾病阶段特异性治疗的生物标志物，其中可能包括抗病毒和免疫调节剂。