{"id":1764,"date":"2021-08-11T16:42:32","date_gmt":"2021-08-11T16:42:32","guid":{"rendered":"http:\/\/wp.cov19longhaulfoundation.org\/?p=1764"},"modified":"2021-08-11T16:42:32","modified_gmt":"2021-08-11T16:42:32","slug":"pathophysiology-of-acute-respiratory-syndrome-coronavirus-2-infection-a-systematic-literature-review-to-inform-eular-points-to-consider","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=1764","title":{"rendered":"Pathophysiology of acute respiratory syndrome coronavirus 2 infection: a systematic literature review to inform EULAR points to consider"},"content":{"rendered":"\n

Authors: Aur\u00e9lie Najm1<\/a>,\u00a0http:\/\/orcid.org\/0000-0003-1105-5640<\/a>Alessia Alunno2<\/a>,\u00a0Xavier Mariette3<\/a>,4<\/a>,\u00a0http:\/\/orcid.org\/0000-0001-6612-7336<\/a>Benjamin Terrier5<\/a>,6<\/a>,\u00a0http:\/\/orcid.org\/0000-0003-2406-161X<\/a>Gabriele De Marco7<\/a>,8<\/a>,\u00a0Jenny Emmel9<\/a>,\u00a0Laura Mason9<\/a>,\u00a0Dennis G McGonagle7<\/a>,10<\/a>\u00a0and\u00a0http:\/\/orcid.org\/0000-0002-8411-7972<\/a>Pedro M Machado11<\/a>,12<\/a>,13<\/a><\/p>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/strong> The SARS-CoV-2 pandemic is a global health problem. Beside the specific pathogenic effect of SARS-CoV-2, incompletely understood deleterious and aberrant host immune responses play critical roles in severe disease. Our objective was to summarise the available information on the pathophysiology of COVID-19.<\/p>\n\n\n\n

Methods<\/strong> Two reviewers independently identified eligible studies according to the following PICO framework: P (population): patients with SARS-CoV-2 infection; I (intervention): any intervention\/no intervention; C (comparator): any comparator; O (outcome) any clinical or serological outcome including but not limited to immune cell phenotype and function and serum cytokine concentration.<\/p>\n\n\n\n

Results<\/strong> Of the 55\u2009496 records yielded, 84 articles were eligible for inclusion according to question-specific research criteria. Proinflammatory cytokine expression, including interleukin-6 (IL-6), was increased, especially in severe COVID-19, although not as high as other states with severe systemic inflammation. The myeloid and lymphoid compartments were differentially affected by SARS-CoV-2 infection depending on disease phenotype. Failure to maintain high interferon (IFN) levels was characteristic of severe forms of COVID-19 and could be related to loss-of-function mutations in the IFN pathway and\/or the presence of anti-IFN antibodies. Antibody response to SARS-CoV-2 infection showed a high variability across individuals and disease spectrum. Multiparametric algorithms showed variable diagnostic performances in predicting survival, hospitalisation, disease progression or severity, and mortality.<\/p>\n\n\n\n

Conclusions<\/strong> SARS-CoV-2 infection affects both humoral and cellular immunity depending on both disease severity and individual parameters. This systematic literature review informed the EULAR \u2018points to consider\u2019 on COVID-19 pathophysiology and immunomodulatory therapies.http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/<\/a><\/p>\n\n\n\n

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:\u00a0http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/<\/a>.<\/p>\n\n\n\n

For More Information: https:\/\/rmdopen.bmj.com\/content\/7\/1\/e001549<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Authors: Aur\u00e9lie Najm1,\u00a0http:\/\/orcid.org\/0000-0003-1105-5640Alessia Alunno2,\u00a0Xavier Mariette3,4,\u00a0http:\/\/orcid.org\/0000-0001-6612-7336Benjamin Terrier5,6,\u00a0http:\/\/orcid.org\/0000-0003-2406-161XGabriele De Marco7,8,\u00a0Jenny Emmel9,\u00a0Laura Mason9,\u00a0Dennis G McGonagle7,10\u00a0and\u00a0http:\/\/orcid.org\/0000-0002-8411-7972Pedro M Machado11,12,13 Abstract Background The SARS-CoV-2 pandemic is a global health problem. Beside the specific pathogenic effect of SARS-CoV-2, […]<\/p>\n","protected":false},"author":2,"featured_media":1765,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[663,101,107,252,257,260,524],"tags":[],"class_list":["post-1764","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acute-respiratory-distress","category-covid-19","category-cytokine-storm-covid-19","category-inflammation","category-interferon","category-interleukin","category-severity"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/1764","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1764"}],"version-history":[{"count":0,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/1764\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/1765"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}