Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives—A report of the European Academy of Allergy and Clinical Immunology (EAACI)
Corresponding Author
Milena Sokolowska
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Correspondence
Milena Sokolowska, Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Email: [email protected]
Eva Untersmayr, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090 Vienna, Austria.
Email: [email protected]
Search for more papers by this authorZuzanna M. Lukasik
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Department of Rheumatology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorIoana Agache
Allergy and Clinical Immunology, Transylvania University, Brasov, Romania
Search for more papers by this authorCezmi A. Akdis
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Search for more papers by this authorDeniz Akdis
University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorMübeccel Akdis
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Search for more papers by this authorWeronika Barcik
Genetics of Cognition laboratory, Istituto Italiano di Tecnologia, Genova, Italy
Search for more papers by this authorHelen A. Brough
Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, St. Thomas' Hospital, King's College London, London, UK
Children's Allergy Service, Evelina Children's Hospital, Guy's and St.Thomas' Hospital NHS Foundation Trust, London, UK
Paediatric Allergy Group, Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Guys' Hospital, King's College London, London, UK
Search for more papers by this authorThomas Eiwegger
Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada
Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
Department of Immunology, University of Toronto, Toronto, ON, Canada
Search for more papers by this authorAndrzej Eljaszewicz
Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorStefanie Eyerich
Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
Search for more papers by this authorWojciech Feleszko
Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorCristina Gomez-Casado
Institute of Applied Molecular Medicine, Hospitals Madrid (HM) Group, San Pablo-CEU University, Madrid, Spain
ARADyAL, RD16/0006/0015, Thematic Network and Cooperative Research Centers, ISCIII, Madrid, Spain
Search for more papers by this authorKarin Hoffmann-Sommergruber
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorJozef Janda
Faculty of Science, Charles University, Prague, Czech Republic
Search for more papers by this authorRodrigo Jiménez-Saiz
Department of Immunology and Oncology, Centro Nacional de Biotecnología (CNB-CSIC), Madrid, Spain
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorMarek Jutel
Department of Clinical Immunology, Wroclaw Medical University, Wrocław, Poland
ALL-MED Medical Research Institute, Wroclaw, Poland
Search for more papers by this authorEdward F. Knol
Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorInge Kortekaas Krohn
SKIN Research Group, Department of Dermatology, Vrije Universiteit Brussel/Universitair Ziekenhuis Brussel, Brussels, Belgium
Search for more papers by this authorAkash Kothari
Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorJoanna Makowska
Department of Rheumatology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMarcin Moniuszko
Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
Department of Allergology and Internal Medicine, Medical University of Bialystok, Poland
Search for more papers by this authorHideaki Morita
Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Japan
Search for more papers by this authorLiam O'Mahony
Departments of Medicine and Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
Search for more papers by this authorKari Nadeau
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USA
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA
Search for more papers by this authorCevdet Ozdemir
Department of Pediatric Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Search for more papers by this authorIsabella Pali-Schöll
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Comparative Medicine, Interuniversity Messerli Research Institute, University of Veterinary Medicine and Medical University Vienna, Austria
Search for more papers by this authorOscar Palomares
Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid, Spain
Search for more papers by this authorFrancesco Papaleo
Genetics of Cognition laboratory, Istituto Italiano di Tecnologia, Genova, Italy
Search for more papers by this authorMary Prunicki
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USA
Search for more papers by this authorCarsten B. Schmidt-Weber
Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
Search for more papers by this authorAnna Sediva
Department of Immunology, Motol University Hospital, 2nd Faculty of Medicine, Charles University, Prague
Search for more papers by this authorJürgen Schwarze
Centre for Inflammation Research and Child Life and Health, The University of Edinburgh, Edinburgh, UK
Search for more papers by this authorMohamed H. Shamji
Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
Search for more papers by this authorGerdien A. Tramper-Stranders
Department of Paediatric Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
Search for more papers by this authorWillem van de Veen
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Search for more papers by this authorCorresponding Author
Eva Untersmayr
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Correspondence
Milena Sokolowska, Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Email: [email protected]
Eva Untersmayr, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090 Vienna, Austria.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Milena Sokolowska
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Correspondence
Milena Sokolowska, Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Email: [email protected]
Eva Untersmayr, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090 Vienna, Austria.
Email: [email protected]
Search for more papers by this authorZuzanna M. Lukasik
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Department of Rheumatology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorIoana Agache
Allergy and Clinical Immunology, Transylvania University, Brasov, Romania
Search for more papers by this authorCezmi A. Akdis
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Search for more papers by this authorDeniz Akdis
University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorMübeccel Akdis
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Search for more papers by this authorWeronika Barcik
Genetics of Cognition laboratory, Istituto Italiano di Tecnologia, Genova, Italy
Search for more papers by this authorHelen A. Brough
Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, St. Thomas' Hospital, King's College London, London, UK
Children's Allergy Service, Evelina Children's Hospital, Guy's and St.Thomas' Hospital NHS Foundation Trust, London, UK
Paediatric Allergy Group, Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Guys' Hospital, King's College London, London, UK
Search for more papers by this authorThomas Eiwegger
Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada
Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
Department of Immunology, University of Toronto, Toronto, ON, Canada
Search for more papers by this authorAndrzej Eljaszewicz
Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorStefanie Eyerich
Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
Search for more papers by this authorWojciech Feleszko
Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorCristina Gomez-Casado
Institute of Applied Molecular Medicine, Hospitals Madrid (HM) Group, San Pablo-CEU University, Madrid, Spain
ARADyAL, RD16/0006/0015, Thematic Network and Cooperative Research Centers, ISCIII, Madrid, Spain
Search for more papers by this authorKarin Hoffmann-Sommergruber
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorJozef Janda
Faculty of Science, Charles University, Prague, Czech Republic
Search for more papers by this authorRodrigo Jiménez-Saiz
Department of Immunology and Oncology, Centro Nacional de Biotecnología (CNB-CSIC), Madrid, Spain
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorMarek Jutel
Department of Clinical Immunology, Wroclaw Medical University, Wrocław, Poland
ALL-MED Medical Research Institute, Wroclaw, Poland
Search for more papers by this authorEdward F. Knol
Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorInge Kortekaas Krohn
SKIN Research Group, Department of Dermatology, Vrije Universiteit Brussel/Universitair Ziekenhuis Brussel, Brussels, Belgium
Search for more papers by this authorAkash Kothari
Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorJoanna Makowska
Department of Rheumatology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMarcin Moniuszko
Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
Department of Allergology and Internal Medicine, Medical University of Bialystok, Poland
Search for more papers by this authorHideaki Morita
Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Japan
Search for more papers by this authorLiam O'Mahony
Departments of Medicine and Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
Search for more papers by this authorKari Nadeau
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USA
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA
Search for more papers by this authorCevdet Ozdemir
Department of Pediatric Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Search for more papers by this authorIsabella Pali-Schöll
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Comparative Medicine, Interuniversity Messerli Research Institute, University of Veterinary Medicine and Medical University Vienna, Austria
Search for more papers by this authorOscar Palomares
Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid, Spain
Search for more papers by this authorFrancesco Papaleo
Genetics of Cognition laboratory, Istituto Italiano di Tecnologia, Genova, Italy
Search for more papers by this authorMary Prunicki
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USA
Search for more papers by this authorCarsten B. Schmidt-Weber
Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
Search for more papers by this authorAnna Sediva
Department of Immunology, Motol University Hospital, 2nd Faculty of Medicine, Charles University, Prague
Search for more papers by this authorJürgen Schwarze
Centre for Inflammation Research and Child Life and Health, The University of Edinburgh, Edinburgh, UK
Search for more papers by this authorMohamed H. Shamji
Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
Search for more papers by this authorGerdien A. Tramper-Stranders
Department of Paediatric Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
Search for more papers by this authorWillem van de Veen
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
Search for more papers by this authorCorresponding Author
Eva Untersmayr
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Correspondence
Milena Sokolowska, Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Email: [email protected]
Eva Untersmayr, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090 Vienna, Austria.
Email: [email protected]
Search for more papers by this authorAbstract
With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.
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