Interactions of Influenza and SARS-CoV-2 with the Lung Endothelium: Similarities, Differences, and Implications for Therapy

Viruses. 2021 Jan 22;13(2):161. doi: 10.3390/v13020161.


Respiratory viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a constant threat to public health given their ability to cause global pandemics. Infection with either virus may lead to aberrant host responses, such as excessive immune cell recruitment and activation, dysregulated inflammation, and coagulopathy. These may contribute to the development of lung edema and respiratory failure. An increasing amount of evidence suggests that lung endothelial cells play a critical role in the pathogenesis of both viruses. In this review, we discuss how infection with influenza or SARS-CoV-2 may induce endothelial dysfunction. We compare the effects of infection of these two viruses, how they may contribute to pathogenesis, and discuss the implications for potential treatment. Understanding the differences between the effects of these two viruses on lung endothelial cells will provide important insight to guide the development of therapeutics.

Keywords: SARS-CoV-2; endothelium; influenza; lung injury; vascular stability.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Platelets / metabolism
  • Cytokines / metabolism
  • Endothelial Cells / metabolism
  • Endothelial Cells / pathology
  • Endothelium / metabolism
  • Endothelium / pathology
  • Endothelium / virology*
  • Extracellular Traps / immunology
  • Humans
  • Influenzavirus A / pathogenicity*
  • Intercellular Junctions / pathology
  • Lung Injury / pathology*
  • Lung Injury / therapy
  • Lung Injury / virology*
  • SARS-CoV-2 / pathogenicity*


  • Cytokines