COVID-19: Integrating the Complexity of Systemic and Pulmonary Immunopathology to Identify Biomarkers for Different Outcomes

Abstract

In the last few months, the coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide and has provoked an exceptional effort from the scientific community to understand the disease. Clinical evidence suggests that severe COVID-19 is associated with both dysregulation of damage tolerance caused by pulmonary immunopathology and high viral load. In this review article, we describe and discuss clinical studies that show advances in the understanding of mild and severe illness and we highlight major points that are critical for improving the comprehension of different clinical outcomes. The understanding of pulmonary immunopathology will contribute to the identification of biomarkers in an attempt to classify mild, moderate, severe and critical COVID-19 illness. The interface of pulmonary immunopathology and the identification of biomarkers are critical for the development of new therapeutic strategies aimed to reduce the systemic and pulmonary hyperinflammation in severe COVID-19.

Drug repurposing to face Covid-19: Celastrol, a potential leading drug capable of inhibiting SARS-CoV-2 replication and induced inflammation

“…As expected, the reuse of transcriptome data from SARS-CoV-2-infected NHBE cells, a normal human bronchial epithelial cell line, evidenced enriched biological pathways associated with non-hemostatic inflammation, including upregulation of the IL-6 gene expression. A recent review paper from our team has reported the relationship between serum IL-6 levels and different outcomes of Covid-19 patients 90 : compared with severe patients, critical and mild patients have higher and lower IL-6 levels, respectively; and non-survivors exhibit significantly higher IL-6 levels than survivors with Covid-19. In vitro assays using Calu-3, A549, and NHBE cells have confirmed that SARS-CoV-2 infection induces IL-6 production 30 .…”

C-Reactive Protein: Friend or Foe? Phylogeny From Heavy Metals to Modified Lipoproteins and SARS-CoV-2

“…The latter should be considered in particular with respect to the recently described immunological profiles of COVID-19 lungs ( 63 ) suggesting a complex interplay of innate and adaptive immunity underlying the clinical picture. It has to be emphasized, however, that other anti-inflammatory treatment options, for example blocking interleukin-6 or inhibiting the C3 and C5 activation also showed a promising preclinical effect ( 64 ).…”

Seltene Superinfektion bei einem COVID-19-Patienten – Eine Chronologie

“…Allerdings zeigt die Auswertung vieler international durchgeführter Studien ein deutliches Biomarkerprofil in den Inflammationswerten während einer COVID-19-Pneumonie als Ausdruck des Zytokinsturms. Es scheint bei der Interpretation auf die Gesamtheit der Laborparameter anzukommen, nicht auf einen singulären Wert [ 25 ]. Tab.…”