Clinical classification of COVID-19 infection, and the role of complement activation
Disease severity | Percentage of cases | Features/role of complement activation |
---|---|---|
Asymptomatic | 20%–40% | Immune system shuts off the virus; no clinical signs or symptoms of infection; immunity induced; “natural” vaccination Complement activation beneficial |
Upper respiratory tract (cold-like syndrome) | 30%–70% | Virus replicates in upper-airway tissues leading to sore throat, cough, fever, sneezing, altered taste and smell, “typical cold” syndrome; usually lasts 2 to 5 days; recovery in 2 to 3 weeks Complement activation beneficiala |
Moderately severe | 5%–10% | Viral load is greater; extension to deeper parts of the lung (pneumonia) and possibly to other tissues, with prominent inflammatory picture Complement activation not beneficial |
Severe | 1%–5%a | Heavy viral load; extension to extrapulmonary tissues, especially endothelial cell populations; thromboembolic phenomena Virus is never adequately controlledb Virus eventually controlled and eliminated, but often with residual effects Complement activation poor for host |