The disease caused by SARS-CoV-2—CoVID-19—is a global pandemic that has brought severe changes worldwide. Approximately 80% of the infected patients are largely asymptomatic or have mild symptoms such as fever or cough, while rest of the patients display varying degrees of severity of symptoms, with an average mortality rate of 3–4%. Severe symptoms such as pneumonia and acute respiratory distress syndrome may be caused by tissue damage, which is mostly due to aggravated and unresolved innate and adaptive immune response, often resulting from a cytokine storm. Cytokine storm: A sudden acute increase in circulating levels of different inflammation causing cytokines including IL-6, IL-1, etc. Here, we discuss how an intricate interplay among infected cells and cells of innate and adaptive immune system can lead to such diverse clinicopathological outcomes. Particularly, we discuss how the emergent nonlinear dynamics of interaction among the components of adaptive and immune system components and virally infected cells can drive different disease severity. Such minimalistic yet rigorous mathematical modeling approaches are helpful in explaining how various co-morbidity risk factors, such as age and obesity, can aggravate the severity of CoVID-19 in patients. Furthermore, such approaches can elucidate how a fine-tuned balance of infected cell killing and resolution of inflammation can lead to infection clearance, while disruptions can drive different severe phenotypes. These results can help further in a rational selection of drug combinations that can effectively balance viral clearance and minimize tissue damage. Cytokine storm: A sudden acute increase in circulating levels of different inflammation causing cytokines including IL-6, IL-1, etc.

中文翻译：

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好的、坏的和丑陋的：一个数学模型调查 CoVID-19 患者的不同结果

由 SARS-CoV-2 引起的疾病——CoVID-19——是一种全球性流行病，给全世界带来了严重的变化。大约80%的感染患者基本无症状或有发热、咳嗽等轻微症状，其余患者则表现出不同程度的症状严重程度，平均死亡率为3-4%。肺炎和急性呼吸窘迫综合征等严重症状可能是由组织损伤引起的，这主要是由于先天性和适应性免疫反应的加重和未解决，通常是由细胞因子风暴引起的。细胞因子风暴：不同炎症的循环水平突然急剧增加，导致细胞因子包括 IL-6、IL-1 等。这里，我们讨论了感染细胞与先天性和适应性免疫系统细胞之间复杂的相互作用如何导致如此多样化的临床病理学结果。特别是，我们讨论了适应性和免疫系统成分与病毒感染细胞之间相互作用的新兴非线性动力学如何驱动不同的疾病严重程度。这种简约而严谨的数学建模方法有助于解释各种合并症风险因素，如年龄和肥胖，如何加重患者 CoVID-19 的严重程度。此外，这些方法可以阐明感染细胞杀死和炎症消退之间的微调平衡如何导致感染清除，而破坏可以驱动不同的严重表型。这些结果有助于进一步合理选择药物组合，以有效平衡病毒清除并最大限度地减少组织损伤。细胞因子风暴：引起细胞因子（包括 IL-6、IL-1 等）的不同炎症循环水平突然急剧增加。