4.5 Review

Complement inhibition: A possible therapeutic approach in the fight against Covid-19

Journal

REVIEWS IN MEDICAL VIROLOGY
Volume 32, Issue 4, Pages -

Publisher

WILEY
DOI: 10.1002/rmv.2316

Keywords

C5; complement system; Covid-19; membrane attack complex; SARS-CoV-2

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Funding

  1. Shahid Beheshti University of Medical Sciences

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The complement system is an important part of the immune system and plays a key role in pathogen clearance, but over-activation can lead to acute lung injury. The novel coronavirus SARS-CoV-2 has caused the global pandemic of Covid-19, with some individuals developing hyper-inflammatory responses.
The complement system, as a vital part of innate immunity, has an important role in the clearance of pathogens; however, unregulated activation of this system probably has a key role in the pathogenesis of acute lung injury, which is induced by highly pathogenic viruses (i.e. influenza A viruses and severe acute respiratory syndrome [SARS] coronavirus). The novel coronavirus SARS-CoV-2, which is the causal agent for the ongoing global pandemic of the coronavirus disease 2019 (Covid-19), has recently been spread to almost all countries around the world. Although most people are immunocompetent to SARS-CoV-2, a small group develops hyper-inflammation that leads to complications like acute respiratory distress syndrome, disseminated intravascular coagulation, and multi-organ failure. Emerging evidence demonstrates that the complement system exerts a crucial role in this inflammatory reaction. Additionally, patients with the severe form of Covid-19 show over-activation of the complement in their skin, sera, and lungs. This study aims to summarise current knowledge concerning the interaction of SARS-CoV-2 with the complement system and to critically appraise complement inhibition as a potential new approach for Covid-19 treatment.

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