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World J Biol Chem. Sep 27, 2020; 11(2): 14-29
Published online Sep 27, 2020. doi: 10.4331/wjbc.v11.i2.14
Immunological aspects of COVID-19: What do we know?
Tsvetelina Veselinova Velikova, Stanislav Vasilev Kotsev, Daniel Stefanov Georgiev, Hristiana Momchilova Batselova
Tsvetelina Veselinova Velikova, Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Stanislav Vasilev Kotsev, Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, Pazardzhik 4400, Bulgaria
Daniel Stefanov Georgiev, Dental Faculty, Medical University of Plovdiv, Plovdiv 4002, Bulgaria
Hristiana Momchilova Batselova, Department of Epidemiology and Disaster Medicine, Medical University, Plovdiv, University Hospital “St George”, Plovdiv 4002, Bulgaria
Author contributions: Velikova TV, Kotsev SV, Georgiev DS, and Batselova HM contributed equally to this work; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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 and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tsvetelina Veselinova Velikova, MD, PhD, Assistant Professor, Department of Clinical Immunology, University Hospital Lozenetz, Kozyak 1 Street, Sofia 1407, Bulgaria. tsvelikova@medfac.mu-sofia.bg
Received: June 23, 2020
Peer-review started: June 23, 2020
First decision: July 25, 2020
Revised: August 1, 2020
Accepted: September 8, 2020
Article in press: September 8, 2020
Published online: September 27, 2020
Abstract

The newly emerged coronavirus (severe acute respiratory syndrome coronavirus 2 SARS-CoV-2) and the disease that it causes coronavirus disease 2019 (COVID-19) have changed the world we know. Yet, the origin and evolution of SARS-CoV-2 remain mostly vague. Many virulence factors and immune mechanisms contribute to the deteriorating effects on the organism during SARS-CoV-2 infection. Both humoral and cellular immune responses are involved in the pathophysiology of the disease, where the principal and effective immune response towards viral infection is the cell-mediated immunity. The clinical picture of COVID-19, which includes immune memory and reinfection, remains unclear and unpredictable. However, many hopes are put in developing an effective vaccine against the virus, and different therapeutic options have been implemented to find effective, even though not specific, treatment to the disease. We can assume that the interaction between the SARS-CoV-2 virus and the individual's immune system determines the onset and development of the disease significantly.

Keywords: SARS-CoV-2, COVID-19, Immune memory, Anti-SARS-CoV-2 antibodies, COVID-19 treatment, Plasma therapy

Core Tip: Since the coronavirus disease 2019 (COVID-19) results from the interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and the individual′s immune system, we can assume that its onset and development significantly depend on this communication. Immunological aspects of the disease reflect the importance of the immune system to inhibit the viral factors and to control and regulate the pathophysiological processes during SARS-CoV-2 infection. Moreover, immune-mediated and humoral immune responses, immune memory, the cytokine storm, and neuroendocrine-immune regulation are critical factors that can determine the prognosis and outcome for patients. Now, the science is directed to acquiring new data on the immunology, including immune memory against the virus, the development of new technologies for the detection of infection and effective vaccines. However, much more information remains unclear than verified knowledge of the SARS-CoV-2 virus and COVID-19.