Immuno-epidemiology and pathophysiology of coronavirus disease 2019 (COVID-19)
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REVIEW
Immuno-epidemiology and pathophysiology of coronavirus disease 2019 (COVID-19) Omalla A. Olwenyi 1,2 & Shetty Ravi Dyavar 3 & Arpan Acharya 1 & Anthony T. Podany 3 & Courtney V. Fletcher 3 & Caroline L. Ng 2 & St Patrick Reid 2 & Siddappa N. Byrareddy 1,4,5 Received: 31 May 2020 / Revised: 1 August 2020 / Accepted: 6 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Occasional zoonotic viral attacks on immunologically naive populations result in massive death tolls that are capable of threatening human survival. Currently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infectious agent that causes coronavirus disease (COVID-19), has spread from its epicenter in Wuhan China to all parts of the globe. Real-time mapping of new infections across the globe has revealed that variable transmission patterns and pathogenicity are associated with differences in SARS-CoV-2 lineages, clades, and strains. Thus, we reviewed how changes in the SARS-CoV-2 genome and its structural architecture affect viral replication, immune evasion, and transmission within different human populations. We also looked at which immune dominant regions of SARS-CoV-2 and other coronaviruses are recognized by Major Histocompatibility Complex (MHC)/Human Leukocyte Antigens (HLA) genes and how this could impact on subsequent disease pathogenesis. Efforts were also placed on understanding immunological changes that occur when exposed individuals either remain asymptomatic or fail to control the virus and later develop systemic complications. Published autopsy studies that reveal alterations in the lung immune microenvironment, morphological, and pathological changes are also explored within the context of the review. Understanding the true correlates of protection and determining how constant virus evolution impacts on host-pathogen interactions could help identify which populations are at high risk and later inform future vaccine and therapeutic interventions. Keywords SARS-COV-2 . COVID-19 . MHC . HLA . Virus evolution . Pathogenesis
Introduction In this twenty-first century, the resurgence of novel, lethal, and highly contagious zoonotic viruses to which there is no pre-existing immunity pose a great threat to the survival of mankind as described in Table 1[1–3]. The evolutionary
* Siddappa N. Byrareddy [email protected] 1
Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
2
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
3
Antiviral Pharmacology Laboratory, Center for Drug Discovery, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
4
Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA
5
Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA
“arms race” between the host and the pathogen surges on and reaches its crescendo when the infectious agent mutates so
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