Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages

Nat Rev Immunol. 2020 Jun;20(6):355-362. doi: 10.1038/s41577-020-0331-4. Epub 2020 May 6.

Abstract

The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease severity and death in infected patients. Macrophages are a population of innate immune cells that sense and respond to microbial threats by producing inflammatory molecules that eliminate pathogens and promote tissue repair. However, a dysregulated macrophage response can be damaging to the host, as is seen in the macrophage activation syndrome induced by severe infections, including in infections with the related virus SARS-CoV. Here we describe the potentially pathological roles of macrophages during SARS-CoV-2 infection and discuss ongoing and prospective therapeutic strategies to modulate macrophage activation in patients with COVID-19.

Publication types

  • Review

MeSH terms

  • Animals
  • Betacoronavirus / immunology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / pathology
  • Humans
  • Inflammation / etiology*
  • Inflammation / pathology
  • Macrophage Activation / drug effects
  • Macrophages / immunology*
  • Monocytes / immunology
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / pathology

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2