Immune determinants of COVID-19 disease presentation and severity
Immune determinants of COVID-19 disease presentation and severity
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DOI：
10.1038/s41591-020-01202-8
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发表时间：
2021-01-01
期刊：
影响因子：
82.9
通讯作者：
Brodin, Petter
中科院分区：
文献类型：
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作者：
Brodin, Petter
由SARS-CoV-2感染引起的COVID-19在大多数先前健康的个体中为轻度至中度，但在某些情况下可导致危及生命的疾病或持续的衰弱症状。疾病严重程度的最重要决定因素是年龄，65岁以上的人需要重症监护的风险最大，男性比女性更容易受到影响。与其他呼吸道病毒感染相比，幼儿受到的影响似乎不那么严重。现在很清楚，轻度至重度急性感染并不是COVID-19的唯一结果，也可能出现长期持续的症状。与严重急性COVID-19相比，这种“长期COVID”似乎更有可能发生在女性身上。此外，感染后炎症性疾病已被描述为SARS-CoV-2感染后的额外结果。本文将讨论我们目前对COVID-19疾病表现和严重程度的免疫决定因素的理解，并将其与已知的年轻人和老年人之间、男性和女性之间的免疫系统差异以及与不同疾病表现和严重程度相关的其他因素联系起来。COVID-19的严重程度因性别和年龄而异，并与合并症有关。免疫反应的差异可能在某种程度上解释了这一点。
COVID-19, caused by SARS-CoV-2 infection, is mild to moderate in the majority of previously healthy individuals, but can cause life-threatening disease or persistent debilitating symptoms in some cases. The most important determinant of disease severity is age, with individuals over 65 years having the greatest risk of requiring intensive care, and men are more susceptible than women. In contrast to other respiratory viral infections, young children seem to be less severely affected. It is now clear that mild to severe acute infection is not the only outcome of COVID-19, and long-lasting symptoms are also possible. In contrast to severe acute COVID-19, such 'long COVID' is seemingly more likely in women than in men. Also, postinfectious hyperinflammatory disease has been described as an additional outcome after SARS-CoV-2 infection. Here I discuss our current understanding of the immunological determinants of COVID-19 disease presentation and severity and relate this to known immune-system differences between young and old people and between men and women, and other factors associated with different disease presentations and severity.The severity of COVID-19 varies by sex and age, and is linked to comorbidities. Differences in immune reactions may go some way to explain this.