Humoral immune mechanisms involved in protective and pathological immunity during COVID-19 |
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| Affiliation: | 1. Universitas Krisnadwipayana Indonesia, Jakarta, Indonesia;2. Faculty of Biology and Ecology, Yanka Kupala State University of Grodno, Grodno, Belarus;3. College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq;4. Department of Medical Laboratory Sciences, Komar University of Science and Technology, Chaq-Chaq Qularaise, Sulaimaniyah, Iraq;5. Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia;6. Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt;7. Sechenov First Moscow State Medical University, 8 Trubetskaya St., bldg. 2, Moscow 119991, Russian Federation;8. Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, Thailand;9. Department of Immunology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran;10. Department of Hematology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran;11. Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran;12. Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;13. Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran |
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| Abstract: | The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 is associated with excessive inflammation, as a main reason for severe condition and death. Increased inflammatory cytokines and humoral response to SARS-CoV-2 correlate with COVID-19 immunity and pathogenesis. Importantly, the levels of pro-inflammatory cytokines that increase profoundly in systemic circulation appear as part of the clinical pictures of two overlapping conditions, sepsis and the hemophagocytic syndromes. Both conditions can develop lethal inflammatory responses that lead to tissue damage, however, in many patients hemophagocytic lymphohistiocytosis (HLH) can be differentiated from sepsis. This is a key issue because the life-saving aggressive immunosuppressive treatment, required in the HLH therapy, is absent in sepsis guidelines. This paper aims to describe the pathophysiology and clinical relevance of these distinct entities in the course of COVID-19 that resemble sepsis and further highlights two effector arms of the humoral immune response (inflammatory cytokine and immunoglobulin production) during COVID-19 infection. |
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| Keywords: | Antibody response Hemophagocytic lymphohistiocytosis (HLH) 2019 novel coronavirus disease (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Sepsis |
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