ABSTRACT
Knowledge about the pathobiology of SARS-CoV-2 as it interacts with immune defenses is limited. SARS-CoV-2 is spread by droplets that come into contact with mucous membranes. COVID-19 is characterized by 2 or 3 stages: most patients who recover experience 2 stages of illness commencing with an asymptomatic or paucisymptomatic incubation period, followed by a nonsevere symptomatic illness lasting for several weeks, occurring in about 80% of those infected. In the remainder, a third phase marked by a severe respiratory illness, often accompanied by multisystem dysfunction, coagulopathy, and shock is observed. This phase of the illness is characterized by hypercytokinemic inflammation and is often referred to as “cytokine storm.” While the immunopathogenesis remains unclear, prospects of treating this severe phase of the illness with immunotherapy are evolving, with some treatments showing promise.
Footnotes
Dr. Calabrese has disclosed financial interests (consulting, teaching, and speaking) with AbbVie, Bristol Myers Squibb, Crescendo Biologics, GlaxoSmithKline, Genentech/Roche, Horizon Therapeutics, Janssen, Novartis, and Pfizer.
- Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.
- Leonard H. Calabrese, DO⇑
- Department of Rheumatic and Immunologic Diseases, Orthopaedic & Rheumatologic Institute, Cleveland Clinic; Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
- Address:
Leonard H. Calabrese, DO, Department of Rheumatic and Immunologic Diseases, A50, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; calabrl{at}ccf.org
ABSTRACT
Knowledge about the pathobiology of SARS-CoV-2 as it interacts with immune defenses is limited. SARS-CoV-2 is spread by droplets that come into contact with mucous membranes. COVID-19 is characterized by 2 or 3 stages: most patients who recover experience 2 stages of illness commencing with an asymptomatic or paucisymptomatic incubation period, followed by a nonsevere symptomatic illness lasting for several weeks, occurring in about 80% of those infected. In the remainder, a third phase marked by a severe respiratory illness, often accompanied by multisystem dysfunction, coagulopathy, and shock is observed. This phase of the illness is characterized by hypercytokinemic inflammation and is often referred to as “cytokine storm.” While the immunopathogenesis remains unclear, prospects of treating this severe phase of the illness with immunotherapy are evolving, with some treatments showing promise.
Footnotes
Dr. Calabrese has disclosed financial interests (consulting, teaching, and speaking) with AbbVie, Bristol Myers Squibb, Crescendo Biologics, GlaxoSmithKline, Genentech/Roche, Horizon Therapeutics, Janssen, Novartis, and Pfizer.
- Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.