Immune asynchrony in COVID-19 pathogenesis and potential immunotherapies

J Exp Med. 2020 Oct 5;217(10):e20200674. doi: 10.1084/jem.20200674.


The outbreak of coronavirus disease 2019 (COVID-19) is an unprecedented global health crisis. Tissue and peripheral blood analysis indicate profound, aberrant myeloid cell activation, cytokine storm, and lymphopenia, with unknown immunopathological mechanisms. Spatiotemporal control of the quality and quantity of the antiviral immune responses involves synchronized cellular and molecular cascades and cross-talk between innate and adaptive immunity. Dysregulated responses in immunity, such as at the stages of immune sensing, alarming, polarization, and resolution, may contribute to disease pathology. Herein, we approach SARS-CoV-2 through an immunomodulatory lens, discussing possible mechanisms of the asynchronized antiviral immune response and proposing potential therapeutic strategies to correct the dysregulation.

Publication types

  • Review

MeSH terms

  • Betacoronavirus / immunology*
  • Betacoronavirus / physiology
  • COVID-19
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / therapy*
  • Humans
  • Immunity
  • Immunotherapy*
  • Models, Immunological
  • Pandemics
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / therapy*
  • SARS-CoV-2
  • Virus Internalization