4.8 Review

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

Journal

FRONTIERS IN IMMUNOLOGY
Volume 11, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2020.599736

Keywords

coronavirus disease 2019; peripheral immune response; pulmonary inflammation; lung immunopathology; damage tolerance

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Funding

  1. Sao Paulo Research Foundation - FAPESP [2020/05270-0, 2020/05207-6, 2017/21629-5]
  2. National Council for Scientific and Technological Development - CNPq [312606/2019-2, 311639/2017-8, 309583/2019-5]

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This review article discusses the clinical studies on mild and severe COVID-19 illness, highlighting the critical points for understanding different clinical outcomes. The understanding of pulmonary immunopathology will aid in identifying biomarkers and developing new therapeutic strategies to reduce inflammation in severe cases of COVID-19.
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.

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