Abstract

The Coronavirus Disease-2019 (COVID-19) imposed public health emergency and affected millions of people around the globe. As of January 2021, 100 million confirmed cases of COVID-19 along with more than 2 million deaths were reported worldwide. SARS-CoV-2 infection causes excessive production of pro-inflammatory cytokines thereby leading to the development of “Cytokine Storm Syndrome.” This condition results in uncontrollable inflammation that further imposes multiple-organ-failure eventually leading to death. SARS-CoV-2 induces unrestrained innate immune response and impairs adaptive immune responses thereby causing tissue damage. Thus, understanding the foremost features and evolution of innate and adaptive immunity to SARS-CoV-2 is crucial in anticipating COVID-19 outcomes and in developing effective strategies to control the viral spread. In the present review, we exhaustively discuss the sequential key immunological events that occur during SARS-CoV-2 infection and are involved in the immunopathogenesis of COVID-19. In addition to this, we also highlight various therapeutic options already in use such as immunosuppressive drugs, plasma therapy and intravenous immunoglobulins along with various novel potent therapeutic options that should be considered in managing COVID-19 infection such as traditional medicines and probiotics.

摘要

2019 年冠状病毒病 (COVID-19) 引发了公共卫生紧急事件，影响了全球数百万人。截至 2021 年 1 月，全球报告了 1 亿例 COVID-19 确诊病例以及超过 200 万人死亡。SARS-CoV-2 感染导致促炎细胞因子过量产生，从而导致“细胞因子风暴综合症”的发生。这种情况会导致无法控制的炎症，进一步造成多器官衰竭，最终导致死亡。SARS-CoV-2 会诱导不受限制的先天免疫反应并损害适应性免疫反应，从而导致组织损伤。因此，了解 SARS-CoV-2 先天性和适应性免疫的最重要特征和进化对于预测 COVID-19 结果和制定控制病毒传播的有效策略至关重要。在本综述中，我们详尽地讨论了 SARS-CoV-2 感染期间发生的、参与 COVID-19 免疫发病机制的连续关键免疫学事件。除此之外，我们还重点介绍了已经使用的各种治疗方案，例如免疫抑制药物、血浆疗法和静脉注射免疫球蛋白，以及在管理 COVID-19 感染时应考虑的各种新型有效治疗方案，例如传统药物和益生菌。