SARS-CoV-2 might directly activate NLRP3 inflammasome resulting in an endogenous adjuvant activity necessary to mount a proper adaptive immune response against the virus. Heterogeneous response of COVID-19 patients could be attributed to differences in not being able to properly downregulate NLRP3 inflammasome activation. This relates to the fitness of the immune system of the individual challenged by the virus. Patients with a reduced immune fitness can demonstrate a dysregulated NLRP3 inflammasome activity resulting in severe COVID-19 with tissue damage and a cytokine storm. We sketch the outlines of five possible scenarios for COVID-19 in medical practice and provide potential treatment options targeting dysregulated endogenous adjuvant activity in severe COVID-19 patients.

SARS-CoV-2可能会直接激活NLRP3炎性体，从而导致内源性佐剂活性，这是启动针对病毒的适当适应性免疫应答所必需的。COVID-19患者的异质性反应可归因于无法正确下调NLRP3炎性体激活的差异。这涉及被病毒攻击的个体的免疫系统的适应性。免疫适应性降低的患者可能显示NLRP3炎性小体活性失调，导致严重的COVID-19并伴有组织损伤和细胞因子风暴。我们勾画了医学实践中COVID-19的五种可能情况的轮廓，并提供了针对重度COVID-19患者内源性佐剂活性失调的潜在治疗方案。