In a rapidly evolving pandemic such as COVID-19, theories which help unify disparate pre-clinical and clinical observations would be useful. The current pandemic and its pleotropic effects can be explained in part by interaction between SARS-CoV-2 spike protein S, the ACE2/L-SIGN/CD209 receptor on the type II alveolar cell of the lung, and the DC-SIGN receptor on the respiratory dendritic cell (DC) and associated endothelial cells. Infection of the DC by SARS-CoV-2 can potentially explain the exuberant distal immunopathology seen in In a mouse model of severe acute respiratory distress syndrome (SARS), the human disease most related to COVID-19 in clinical course, severe disease is correlated with slow kinetics of SARS-CoV viral clearance 1 . This is accompanied by delayed activation and transit of respiratory DCs to the draining lymph nodes with a deficient virus-specific T cell response 1 . In the SARS-CoV-2 infection, there is initial lymphopenia, and the lymphocyte count is predictive of disease severity and mortality 2 . Lymphocyte counts recover with viral clearance and disease resolution, with adaptive immune cells (CD3+ T cells) being especially important 2 . Such immune deficiency can in part be explained by viral infection and T-cell interaction with the respiratory DC.Early and central infection of tissue resident dendritic cells (DC) by the SARS-CoV-2 coronavirus explain some of the immunopathology of the COVID-19 pandemic. DC are richly abundant in the lung and responsive to viral infection 3 . RNA expression profiling studies demonstrate that human DC express the ACE2 receptor for SARS-CoV-2 4 . In COVID-19, T cell receptor (TCR) repertoires are dramatically reduced during the early onset of severe SARS-CoV-2 infection but recover during the convalescent stage 5 . Such reduction of T cells suggest acute wholesale apoptotic death with engagement of the TCR in the absence of costimulatory molecules, normally provided by DC 6 .DC also express DC-SIGN. DC-SIGN (dendritic cell-specific ICAM-3-grabbing nonintegrin) is a membrane receptor of a C-type lectin family expressed on DCs with a primary function of recognizing high mannose glycans present on other cellular receptors or pathogens 7 . With L-SIGN (CD209L, DC-SIGNR, or liver/lymph specific SIGN) expression, the other SIGN found in humans 8 , these mannose receptors are involved in virus capture and entry into cells 9 . L-SIGN is expressed on human type II alveolar cells, is associated with ACE2 10 , and can enhance ACE2 mediated binding and cellular entry of viral pseudotypes expressing the spike protein S of SARS-CoV 9 .Lentiviral pseudotyped viruses expressing SARS-CoV S protein require acidification of the endosome for viral entry 11 . DC-SIGN mediates binding of these pseudotyped vectors to human DC with uptake into the endosome, followed by polarization of the endosome and delivery of the virus in an "infectious synapse" 11 . This appears similar to an infectious synapse between infected DC and T cells that facilitates HIV infection mediated by...