Mounting evidence supports the importance of mucosal immunity in the immune response to SARS‐CoV‐2. Active virus replication in the upper respiratory tract for the first days of infection opens a new perspective in immunological strategies to counteract viral pathogenicity. An effective mucosal innate immune response to SARS‐CoV‐2 paves the way to an also effective adaptive immune response. A strong local immune response seems to be crucial in the initial contention of the virus by the organism and for triggering the production of the necessary neutralizing antibodies in sera and mucosal secretions. However, if the innate immune response fails to overcome the immune evasion mechanisms displayed by the virus, the infection will progress and the lack of an adaptive immune response will take the patient to an overreactive but ineffective innate immune response. To revert this scenario, an immune strategy based on enhancement of immunity in the first days of infection would be theoretically well come. But serious concerns about cytokine response syndrome prevent us to do so. Fortunately, it is possible to enhance immune system response without causing inflammation through immunomodulation. Immunomodulation of local immune response at the oropharyngeal mucosa could hypothetically activate our mucosal immunity, which could send an early an effective warning to the adaptive immune system. There are studies on immunotherapeutic management of upper respiratory tract infections in children that can place us in the right path to design an immune strategy able to mitigate COVID‐19 symptoms and reduce clinical progression.

中文翻译：

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口腔粘膜免疫调节是SARS-CoV-2感染中临床频谱缓解因素。

越来越多的证据支持粘膜免疫在对SARS-CoV-2的免疫反应中的重要性。在感染的第一天，主动呼吸道病毒在上呼吸道中的复制为抵抗病毒致病性的免疫学策略开辟了新的视角。对SARS-CoV-2的有效粘膜固有免疫反应为获得有效的适应性免疫反应铺平了道路。强烈的局部免疫应答似乎对于机体最初感染病毒以及触发血清和粘膜分泌物中必要的中和抗体的产生至关重要。但是，如果先天免疫反应未能克服病毒显示的免疫逃逸机制，感染将进展，缺乏适应性免疫反应将使患者过度反应，但先天免疫反应无效。为了恢复这种情况，理论上会很好地提出一种基于在感染的头几天增强免疫力的免疫策略。但是，对细胞因子反应综合征的严重关注使我们无法这样做。幸运的是，可以增强免疫系统反应而不会通过免疫调节引起炎症。口咽粘膜局部免疫反应的免疫调节可以假设激活我们的粘膜免疫，这可以向适应性免疫系统发出早期有效警告。