Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)

Milena Sokolowska; Zuzanna M Lukasik; Ioana Agache; Cezmi A Akdis; Deniz Akdis; Mübeccel Akdis; Weronika Barcik; Helen A Brough; Thomas Eiwegger; Andrzej Eljaszewicz; Stefanie Eyerich; Wojciech Feleszko; Cristina Gomez-Casado; Karin Hoffmann-Sommergruber; Jozef Janda; Rodrigo Jiménez-Saiz; Marek Jutel; Edward F Knol; Inge Kortekaas Krohn; Akash Kothari; Joanna Makowska; Marcin Moniuszko; Hideaki Morita; Liam O'Mahony; Kari Nadeau; Cevdet Ozdemir; Isabella Pali-Schöll; Oscar Palomares; Francesco Papaleo; Mary Prunicki; Carsten B Schmidt-Weber; Anna Sediva; Jürgen Schwarze; Mohamed H Shamji; Gerdien A Tramper-Stranders; Willem van de Veen; Eva Untersmayr

doi:10.1111/all.14462

Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)

Milena Sokolowska, Zuzanna M Lukasik, Ioana Agache, Cezmi A Akdis, Deniz Akdis, Mübeccel Akdis, Weronika Barcik, Helen A Brough, Thomas Eiwegger, Andrzej Eljaszewicz, Stefanie Eyerich, Wojciech Feleszko, Cristina Gomez-Casado, Karin Hoffmann-Sommergruber, Jozef Janda, Rodrigo Jiménez-Saiz, Marek Jutel, Edward F Knol, Inge Kortekaas Krohn, Akash KothariJoanna Makowska, Marcin Moniuszko, Hideaki Morita, Liam O'Mahony, Kari Nadeau, Cevdet Ozdemir, Isabella Pali-Schöll, Oscar Palomares, Francesco Papaleo, Mary Prunicki, Carsten B Schmidt-Weber, Anna Sediva, Jürgen Schwarze, Mohamed H Shamji, Gerdien A Tramper-Stranders, Willem van de Veen, Eva Untersmayr

Research output: Journal article (peer-reviewed) › Journal article

130 Citations (Scopus)

Abstract

With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.

Original language	English
Pages (from-to)	2445-2476
Number of pages	32
Journal	Allergy: European Journal of Allergy and Clinical Immunology
Volume	75
Issue number	10
DOIs	https://doi.org/10.1111/all.14462
Publication status	Published - 01 Oct 2020
Externally published	Yes

Keywords

Academies and Institutes
Betacoronavirus/immunology
COVID-19
COVID-19 Testing
Clinical Laboratory Techniques/methods
Coronavirus Infections/diagnosis
Humans
Pandemics
Pneumonia, Viral/diagnosis
SARS-CoV-2
COVID-19 multimorbidity
SARS-CoV-2 receptors
COVID-19 comorbidity
SARS
COVID-19 prevention
COVID-19 immunity
COVID-19 treatment

ASJC Scopus subject areas

Immunology and Allergy
Immunology

Access to Document

10.1111/all.14462

Cite this

Sokolowska, M., Lukasik, Z. M., Agache, I., Akdis, C. A., Akdis, D., Akdis, M., Barcik, W., Brough, H. A., Eiwegger, T., Eljaszewicz, A., Eyerich, S., Feleszko, W., Gomez-Casado, C., Hoffmann-Sommergruber, K., Janda, J., Jiménez-Saiz, R., Jutel, M., Knol, E. F., Kortekaas Krohn, I., ... Untersmayr, E. (2020). Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI). Allergy: European Journal of Allergy and Clinical Immunology, 75(10), 2445-2476. https://doi.org/10.1111/all.14462

@article{57a344f3e6d140c8864348a7e187d6db,

title = "Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)",

abstract = "With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.",

keywords = "Academies and Institutes, Betacoronavirus/immunology, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques/methods, Coronavirus Infections/diagnosis, Humans, Pandemics, Pneumonia, Viral/diagnosis, SARS-CoV-2, COVID-19 multimorbidity, SARS-CoV-2 receptors, COVID-19 comorbidity, SARS, COVID-19 prevention, COVID-19 immunity, COVID-19 treatment",

author = "Milena Sokolowska and Lukasik, {Zuzanna M} and Ioana Agache and Akdis, {Cezmi A} and Deniz Akdis and M{\"u}beccel Akdis and Weronika Barcik and Brough, {Helen A} and Thomas Eiwegger and Andrzej Eljaszewicz and Stefanie Eyerich and Wojciech Feleszko and Cristina Gomez-Casado and Karin Hoffmann-Sommergruber and Jozef Janda and Rodrigo Jim{\'e}nez-Saiz and Marek Jutel and Knol, {Edward F} and {Kortekaas Krohn}, Inge and Akash Kothari and Joanna Makowska and Marcin Moniuszko and Hideaki Morita and Liam O'Mahony and Kari Nadeau and Cevdet Ozdemir and Isabella Pali-Sch{\"o}ll and Oscar Palomares and Francesco Papaleo and Mary Prunicki and Schmidt-Weber, {Carsten B} and Anna Sediva and J{\"u}rgen Schwarze and Shamji, {Mohamed H} and Tramper-Stranders, {Gerdien A} and {van de Veen}, Willem and Eva Untersmayr",

note = "Funding Information: We thank Urszula Radzikowska from the Swiss Institute of Allergy and Asthma Research (SIAF) for her contribution in preparing Figure 2. The authors would like to thank the European Academy of Allergy and Clinical Immunology (EAACI) for the financial support to the sections, interest groups and working groups enabling the development of this paper. The research of SM is supported by a SNSF grant 310039_189334; JSR is funded by Ministerio de Econom{\'i}a y Competitividad (IJCI‐2016‐27619); KKI is supported by the FWO Post doc mandate 12W2219N; BW and PF were supported by funding from the Istituto Italiano di Tecnologia, Fondazione Telethon (project GGP19103), and Ricerca Finalizzata Giovani Ricercatori 2016 ‐ Ministero Salute Italia (project GR‐2016‐02362413); GCC is supported by a postdoctoral contract cofounded by the competitive Program “Attracting Talent,” Community of Madrid, Spain; the research of SWCB was funded by DFG (398577603), “ADAPT” EIT Health is a body of the EU receiving support from H2020 and BMBF “ESCAPE” 01KI20169A; the research of UE is supported by the H2020 grant 768641 and by the BMF grant 19056. Funding Information: We thank Urszula Radzikowska from the Swiss Institute of Allergy and Asthma Research (SIAF) for her contribution in preparing Figure 2. The authors would like to thank the European Academy of Allergy and Clinical Immunology (EAACI) for the financial support to the sections, interest groups and working groups enabling the development of this paper. The research of SM is supported by a SNSF grant 310039_189334; JSR is funded by Ministerio de Econom{\'i}a y Competitividad (IJCI-2016-27619); KKI is supported by the FWO Post doc mandate 12W2219N; BW and PF were supported by funding from the Istituto Italiano di Tecnologia, Fondazione Telethon (project GGP19103), and Ricerca Finalizzata Giovani Ricercatori 2016 - Ministero Salute Italia (project GR-2016-02362413); GCC is supported by a postdoctoral contract cofounded by the competitive Program “Attracting Talent,” Community of Madrid, Spain; the research of SWCB was funded by DFG (398577603), “ADAPT” EIT Health is a body of the EU receiving support from H2020 and BMBF “ESCAPE” 01KI20169A; the research of UE is supported by the H2020 grant 768641 and by the BMF grant 19056. Dr Agache reports being Associate Editor Allergy journal. Dr Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine K{\"u}hne-Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith-Kline and other from Sanofi & Regeneron. Dr Eiwegger reports other from DBV, grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co-I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr Jutel reports personal fees from ALK-Abello, personal fees from Allergopharma, personal fees from Stallergenes, personal fees from Anergis, personal fees from Allergy Therapeutics, personal fees from Circassia, personal fees from Leti, personal fees from Biomay, personal fees from HAL, during the conduct of the study; personal fees from Astra-Zeneka, personal fees from GSK, personal fees from Novartis, personal fees from Teva, personal fees from Vectura, personal fees from UCB, personal fees from Takeda, personal fees from Roche, personal fees from Janssen, personal fees from Medimmune, personal fees from Chiesi, outside the submitted work; Dr Nadeau reports grants and other from NIAID, other from Novartis, personal fees and other from Regeneron, grants and other from FARE, grants from EAT, other from Sanofi, other from Astellas, other from Nestle, other from BeforeBrands, other from Alladapt, other from ForTra, other from Genentech, other from AImmune Therapeutics, other from DBV Technologies, personal fees from Astrazeneca, personal fees from ImmuneWorks, personal fees from Cour Pharmaceuticals, grants from Allergenis, grants from Ukko Pharma, other from AnaptysBio, other from Adare Pharmaceuticals, other from Stallergenes-Greer, other from NHLBI, other from NIEHS, other from EPA, other from WAO Center of Excellence, other from Iggenix, other from Probio, other from Vedanta, other from Centecor, other from Seed, from Immune Tolerance Network, from NIH, outside the submitted work; In addition, Dr Nadeau has a patent Inhibition of Allergic Reaction to Peanut Allergen using an IL-33 Inhibitor pending, a patent Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy pending, a patent Basophil Activation Based Diagnostic Allergy Test pending, a patent Granulocyte-based methods for detecting and monitoring immune system disorders pending, a patent Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders pending, a patent Mixed Allergen Compositions and Methods for Using the Same pending, and a patent Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation pending. Dr O'Mahony reports personal fees from AHL, grants from GSK, outside the submitted work; Dr Palomares reports research grants from Inmunotek SL, Novartis and MINECO (SAF2017-84978-R), has received fees for giving scientific lectures from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi-Genzyme and Stallergenes and has participated in advisory boards from Novartis and Sanofi-Genezyme. Prof. Schmidt-Weber reports grants from EIT Health, body of the EU; grants from German Ministery of Education and Research (BMBF); grants from DFG, during the conduct of the study; In addition, Dr Schmidt-Weber has a patent on drug repurposing pending Dr Schwarze reports personal fees from MYLAN, personal fees from F2F events, outside the submitted work; Industry support to educational activities of the Scottish Allergy and Respiratory Academy and of the Children's and Young people's Allergy Networtk Scotland. Industry support to EAACI, Dr Schwarze is EAACI Secretary General 2019-2021. Dr Sokolowska reports grants from Swiss National Science Foundation, grants from GSK, outside the submitted work; all other authors have nothing to disclose. Funding Information: Dr Agache reports being Associate Editor Allergy journal. Dr Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine K{\"u}hne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith‐Kline and other from Sanofi & Regeneron. Dr Eiwegger reports other from DBV , grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co‐I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr Jutel reports personal fees from ALK‐Abello, personal fees from Allergopharma , personal fees from Stallergenes, personal fees from Anergis, personal fees from Allergy Therapeutics, personal fees from Circassia, personal fees from Leti, personal fees from Biomay, personal fees from HAL, during the conduct of the study; personal fees from Astra‐Zeneka, personal fees from GSK, personal fees from Novartis, personal fees from Teva, personal fees from Vectura, personal fees from UCB, personal fees from Takeda, personal fees from Roche, personal fees from Janssen, personal fees from Medimmune, personal fees from Chiesi, outside the submitted work; Dr Nadeau reports grants and other from NIAID, other from Novartis, personal fees and other from Regeneron, grants and other from FARE, grants from EAT, other from Sanofi, other from Astellas, other from Nestle, other from BeforeBrands, other from Alladapt, other from ForTra, other from Genentech, other from AImmune Therapeutics, other from DBV Technologies, personal fees from Astrazeneca, personal fees from ImmuneWorks, personal fees from Cour Pharmaceuticals, grants from Allergenis , grants from Ukko Pharma, other from AnaptysBio, other from Adare Pharmaceuticals, other from Stallergenes‐Greer, other from NHLBI, other from NIEHS, other from EPA, other from WAO Center of Excellence, other from Iggenix, other from Probio, other from Vedanta, other from Centecor, other from Seed, from Immune Tolerance Network, from NIH, outside the submitted work; In addition, Dr Nadeau has a patent Inhibition of Allergic Reaction to Peanut Allergen using an IL‐33 Inhibitor pending, a patent Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy pending, a patent Basophil Activation Based Diagnostic Allergy Test pending, a patent Granulocyte‐based methods for detecting and monitoring immune system disorders pending, a patent Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders pending, a patent Mixed Allergen Compositions and Methods for Using the Same pending, and a patent Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation pending. Dr O'Mahony reports personal fees from AHL, grants from GSK, outside the submitted work; Dr Palomares reports research grants from Inmunotek SL, Novartis and MINECO (SAF2017‐84978‐R), has received fees for giving scientific lectures from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi‐Genzyme and Stallergenes and has participated in advisory boards from Novartis and Sanofi‐Genezyme. Prof. Schmidt‐Weber reports grants from EIT Health, body of the EU; grants from German Ministery of Education and Research (BMBF); grants from DFG, during the conduct of the study; In addition, Dr Schmidt‐Weber has a patent on drug repurposing pending Dr Schwarze reports personal fees from MYLAN, personal fees from F2F events, outside the submitted work; Industry support to educational activities of the Scottish Allergy and Respiratory Academy and of the Children's and Young people's Allergy Networtk Scotland. Industry support to EAACI, Dr Schwarze is EAACI Secretary General 2019‐2021. Dr Sokolowska reports grants from Swiss National Science Foundation, grants from GSK, outside the submitted work; all other authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.",

year = "2020",

month = oct,

day = "1",

doi = "10.1111/all.14462",

language = "English",

volume = "75",

pages = "2445--2476",

journal = "Allergy: European Journal of Allergy and Clinical Immunology",

issn = "0105-4538",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "10",

}

Sokolowska, M, Lukasik, ZM, Agache, I, Akdis, CA, Akdis, D, Akdis, M, Barcik, W, Brough, HA, Eiwegger, T, Eljaszewicz, A, Eyerich, S, Feleszko, W, Gomez-Casado, C, Hoffmann-Sommergruber, K, Janda, J, Jiménez-Saiz, R, Jutel, M, Knol, EF, Kortekaas Krohn, I, Kothari, A, Makowska, J, Moniuszko, M, Morita, H, O'Mahony, L, Nadeau, K, Ozdemir, C, Pali-Schöll, I, Palomares, O, Papaleo, F, Prunicki, M, Schmidt-Weber, CB, Sediva, A, Schwarze, J, Shamji, MH, Tramper-Stranders, GA, van de Veen, W & Untersmayr, E 2020, 'Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)', Allergy: European Journal of Allergy and Clinical Immunology, vol. 75, no. 10, pp. 2445-2476. https://doi.org/10.1111/all.14462

Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI). / Sokolowska, Milena; Lukasik, Zuzanna M; Agache, Ioana et al.
In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 75, No. 10, 01.10.2020, p. 2445-2476.

Research output: Journal article (peer-reviewed) › Journal article

TY - JOUR

T1 - Immunology of COVID-19

T2 - Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)

AU - Sokolowska, Milena

AU - Lukasik, Zuzanna M

AU - Agache, Ioana

AU - Akdis, Cezmi A

AU - Akdis, Deniz

AU - Akdis, Mübeccel

AU - Barcik, Weronika

AU - Brough, Helen A

AU - Eiwegger, Thomas

AU - Eljaszewicz, Andrzej

AU - Eyerich, Stefanie

AU - Feleszko, Wojciech

AU - Gomez-Casado, Cristina

AU - Hoffmann-Sommergruber, Karin

AU - Janda, Jozef

AU - Jiménez-Saiz, Rodrigo

AU - Jutel, Marek

AU - Knol, Edward F

AU - Kortekaas Krohn, Inge

AU - Kothari, Akash

AU - Makowska, Joanna

AU - Moniuszko, Marcin

AU - Morita, Hideaki

AU - O'Mahony, Liam

AU - Nadeau, Kari

AU - Ozdemir, Cevdet

AU - Pali-Schöll, Isabella

AU - Palomares, Oscar

AU - Papaleo, Francesco

AU - Prunicki, Mary

AU - Schmidt-Weber, Carsten B

AU - Sediva, Anna

AU - Schwarze, Jürgen

AU - Shamji, Mohamed H

AU - Tramper-Stranders, Gerdien A

AU - van de Veen, Willem

AU - Untersmayr, Eva

N1 - Funding Information: We thank Urszula Radzikowska from the Swiss Institute of Allergy and Asthma Research (SIAF) for her contribution in preparing Figure 2. The authors would like to thank the European Academy of Allergy and Clinical Immunology (EAACI) for the financial support to the sections, interest groups and working groups enabling the development of this paper. The research of SM is supported by a SNSF grant 310039_189334; JSR is funded by Ministerio de Economía y Competitividad (IJCI‐2016‐27619); KKI is supported by the FWO Post doc mandate 12W2219N; BW and PF were supported by funding from the Istituto Italiano di Tecnologia, Fondazione Telethon (project GGP19103), and Ricerca Finalizzata Giovani Ricercatori 2016 ‐ Ministero Salute Italia (project GR‐2016‐02362413); GCC is supported by a postdoctoral contract cofounded by the competitive Program “Attracting Talent,” Community of Madrid, Spain; the research of SWCB was funded by DFG (398577603), “ADAPT” EIT Health is a body of the EU receiving support from H2020 and BMBF “ESCAPE” 01KI20169A; the research of UE is supported by the H2020 grant 768641 and by the BMF grant 19056. Funding Information: We thank Urszula Radzikowska from the Swiss Institute of Allergy and Asthma Research (SIAF) for her contribution in preparing Figure 2. The authors would like to thank the European Academy of Allergy and Clinical Immunology (EAACI) for the financial support to the sections, interest groups and working groups enabling the development of this paper. The research of SM is supported by a SNSF grant 310039_189334; JSR is funded by Ministerio de Economía y Competitividad (IJCI-2016-27619); KKI is supported by the FWO Post doc mandate 12W2219N; BW and PF were supported by funding from the Istituto Italiano di Tecnologia, Fondazione Telethon (project GGP19103), and Ricerca Finalizzata Giovani Ricercatori 2016 - Ministero Salute Italia (project GR-2016-02362413); GCC is supported by a postdoctoral contract cofounded by the competitive Program “Attracting Talent,” Community of Madrid, Spain; the research of SWCB was funded by DFG (398577603), “ADAPT” EIT Health is a body of the EU receiving support from H2020 and BMBF “ESCAPE” 01KI20169A; the research of UE is supported by the H2020 grant 768641 and by the BMF grant 19056. Dr Agache reports being Associate Editor Allergy journal. Dr Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine Kühne-Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith-Kline and other from Sanofi & Regeneron. Dr Eiwegger reports other from DBV, grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co-I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr Jutel reports personal fees from ALK-Abello, personal fees from Allergopharma, personal fees from Stallergenes, personal fees from Anergis, personal fees from Allergy Therapeutics, personal fees from Circassia, personal fees from Leti, personal fees from Biomay, personal fees from HAL, during the conduct of the study; personal fees from Astra-Zeneka, personal fees from GSK, personal fees from Novartis, personal fees from Teva, personal fees from Vectura, personal fees from UCB, personal fees from Takeda, personal fees from Roche, personal fees from Janssen, personal fees from Medimmune, personal fees from Chiesi, outside the submitted work; Dr Nadeau reports grants and other from NIAID, other from Novartis, personal fees and other from Regeneron, grants and other from FARE, grants from EAT, other from Sanofi, other from Astellas, other from Nestle, other from BeforeBrands, other from Alladapt, other from ForTra, other from Genentech, other from AImmune Therapeutics, other from DBV Technologies, personal fees from Astrazeneca, personal fees from ImmuneWorks, personal fees from Cour Pharmaceuticals, grants from Allergenis, grants from Ukko Pharma, other from AnaptysBio, other from Adare Pharmaceuticals, other from Stallergenes-Greer, other from NHLBI, other from NIEHS, other from EPA, other from WAO Center of Excellence, other from Iggenix, other from Probio, other from Vedanta, other from Centecor, other from Seed, from Immune Tolerance Network, from NIH, outside the submitted work; In addition, Dr Nadeau has a patent Inhibition of Allergic Reaction to Peanut Allergen using an IL-33 Inhibitor pending, a patent Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy pending, a patent Basophil Activation Based Diagnostic Allergy Test pending, a patent Granulocyte-based methods for detecting and monitoring immune system disorders pending, a patent Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders pending, a patent Mixed Allergen Compositions and Methods for Using the Same pending, and a patent Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation pending. Dr O'Mahony reports personal fees from AHL, grants from GSK, outside the submitted work; Dr Palomares reports research grants from Inmunotek SL, Novartis and MINECO (SAF2017-84978-R), has received fees for giving scientific lectures from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi-Genzyme and Stallergenes and has participated in advisory boards from Novartis and Sanofi-Genezyme. Prof. Schmidt-Weber reports grants from EIT Health, body of the EU; grants from German Ministery of Education and Research (BMBF); grants from DFG, during the conduct of the study; In addition, Dr Schmidt-Weber has a patent on drug repurposing pending Dr Schwarze reports personal fees from MYLAN, personal fees from F2F events, outside the submitted work; Industry support to educational activities of the Scottish Allergy and Respiratory Academy and of the Children's and Young people's Allergy Networtk Scotland. Industry support to EAACI, Dr Schwarze is EAACI Secretary General 2019-2021. Dr Sokolowska reports grants from Swiss National Science Foundation, grants from GSK, outside the submitted work; all other authors have nothing to disclose. Funding Information: Dr Agache reports being Associate Editor Allergy journal. Dr Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine Kühne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith‐Kline and other from Sanofi & Regeneron. Dr Eiwegger reports other from DBV , grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co‐I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr Jutel reports personal fees from ALK‐Abello, personal fees from Allergopharma , personal fees from Stallergenes, personal fees from Anergis, personal fees from Allergy Therapeutics, personal fees from Circassia, personal fees from Leti, personal fees from Biomay, personal fees from HAL, during the conduct of the study; personal fees from Astra‐Zeneka, personal fees from GSK, personal fees from Novartis, personal fees from Teva, personal fees from Vectura, personal fees from UCB, personal fees from Takeda, personal fees from Roche, personal fees from Janssen, personal fees from Medimmune, personal fees from Chiesi, outside the submitted work; Dr Nadeau reports grants and other from NIAID, other from Novartis, personal fees and other from Regeneron, grants and other from FARE, grants from EAT, other from Sanofi, other from Astellas, other from Nestle, other from BeforeBrands, other from Alladapt, other from ForTra, other from Genentech, other from AImmune Therapeutics, other from DBV Technologies, personal fees from Astrazeneca, personal fees from ImmuneWorks, personal fees from Cour Pharmaceuticals, grants from Allergenis , grants from Ukko Pharma, other from AnaptysBio, other from Adare Pharmaceuticals, other from Stallergenes‐Greer, other from NHLBI, other from NIEHS, other from EPA, other from WAO Center of Excellence, other from Iggenix, other from Probio, other from Vedanta, other from Centecor, other from Seed, from Immune Tolerance Network, from NIH, outside the submitted work; In addition, Dr Nadeau has a patent Inhibition of Allergic Reaction to Peanut Allergen using an IL‐33 Inhibitor pending, a patent Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy pending, a patent Basophil Activation Based Diagnostic Allergy Test pending, a patent Granulocyte‐based methods for detecting and monitoring immune system disorders pending, a patent Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders pending, a patent Mixed Allergen Compositions and Methods for Using the Same pending, and a patent Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation pending. Dr O'Mahony reports personal fees from AHL, grants from GSK, outside the submitted work; Dr Palomares reports research grants from Inmunotek SL, Novartis and MINECO (SAF2017‐84978‐R), has received fees for giving scientific lectures from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi‐Genzyme and Stallergenes and has participated in advisory boards from Novartis and Sanofi‐Genezyme. Prof. Schmidt‐Weber reports grants from EIT Health, body of the EU; grants from German Ministery of Education and Research (BMBF); grants from DFG, during the conduct of the study; In addition, Dr Schmidt‐Weber has a patent on drug repurposing pending Dr Schwarze reports personal fees from MYLAN, personal fees from F2F events, outside the submitted work; Industry support to educational activities of the Scottish Allergy and Respiratory Academy and of the Children's and Young people's Allergy Networtk Scotland. Industry support to EAACI, Dr Schwarze is EAACI Secretary General 2019‐2021. Dr Sokolowska reports grants from Swiss National Science Foundation, grants from GSK, outside the submitted work; all other authors have nothing to disclose. Publisher Copyright: © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

PY - 2020/10/1

Y1 - 2020/10/1

N2 - With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.

AB - With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.

KW - Academies and Institutes

KW - Betacoronavirus/immunology

KW - COVID-19

KW - COVID-19 Testing

KW - Clinical Laboratory Techniques/methods

KW - Coronavirus Infections/diagnosis

KW - Humans

KW - Pandemics

KW - Pneumonia, Viral/diagnosis

KW - SARS-CoV-2

KW - COVID-19 multimorbidity

KW - SARS-CoV-2 receptors

KW - COVID-19 comorbidity

KW - SARS

KW - COVID-19 prevention

KW - COVID-19 immunity

KW - COVID-19 treatment

UR - http://www.scopus.com/inward/record.url?scp=85088253490&partnerID=8YFLogxK

U2 - 10.1111/all.14462

DO - 10.1111/all.14462

M3 - Journal article

C2 - 32584441

SN - 0105-4538

VL - 75

SP - 2445

EP - 2476

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

IS - 10

ER -

Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI)

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