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1. Immunology of COVID‐19: mechanisms, clinical outcome, diagnostics and perspectives – a report of the European Academy of Allergy and Clinical Immunology (EAACI)

Author

Wojciech Feleszko, Isabella Pali-Schöll, Weronika Barcik, Jozef Janda, Hideaki Morita, Rodrigo Jiménez-Saiz, Gerdien A. Tramper-Stranders, Willem van de Veen, Kari C. Nadeau, Marcin Moniuszko, Akash Kothari, Oscar Palomares, Cezmi A. Akdis, Cristina Gomez-Casado, Karin Hoffmann-Sommergruber, Stefanie Eyerich, Inge Kortekaas Krohn, Joanna Makowska, Mohamed H. Shamji, Carsten B. Schmidt-Weber, Anna Sediva, Helen A. Brough, Mary Prunicki, Zuzanna Lukasik, Eva Untersmayr, Francesco Papaleo, Milena Sokolowska, Mübeccel Akdis, Ioana Agache, Cevdet Ozdemir, Andrzej Eljaszewicz, Thomas Eiwegger, Edward F. Knol, Deniz Akdis, Marek Jutel, Jürgen Schwarze, Liam O'Mahony, European Academy of Allergy and Clinical Immunology, Swiss National Science Foundation, Ministerio de Economía y Competitividad (España), Research Foundation - Flanders, Istituto Italiano di Tecnologia, Fondazione Telethon, Ministero della Salute, Comunidad de Madrid, German Research Foundation, European Commission, Sokolowska, Milena, Agache, Ioana, Akdis, Cezmi A., Akdis, Mubeccel, Barcik, Weronika, Brough, Helen, Eiwegger, Thomas, Eliaszewicz, Andrzej, Feleszko, Wojciech, Gómez-Casado, C., Hoffmann-Sommergruber, Karin, Janda, Jozef, Jiménez Saiz, Rodrigo, Knol, Edward, Krohn, Kortekaas, Kothari, Akash, Moniuszko, Marcin, Morita, Hideaki, Nadeau, Kari C., Ozdemir, Cevdet, Pali-Schöll, Isabella, Palomares, O., Papaleo, Francesco, Prunicki, Mary, Schmidt-Weber, C. B., Schwarze, Jürgen, Tramper-Stranders, Gerdien, Veen, Willem van de, Untersmayr, Eva, Dermatology, Sokolowska, Milena [0000-0001-9710-6685], Agache, Ioana [0000-0001-7994-364X], Akdis, Cezmi A. [0000-0001-8020-019X], Akdis, Mubeccel [0000-0003-0554-9943], Barcik, Weronika [0000-0001-8580-9690], Brough, Helen [0000-0001-7203-0813], Eiwegger, Thomas [0000-0002-2914-7829], Eliaszewicz, Andrzej [0000-0002-8980-1474], Feleszko, Wojciech [0000-0001-6613-2012], Gómez-Casado, C. [0000-0002-7707-6367], Hoffmann-Sommergruber, Karin [0000-0002-8830-058X], Janda, Jozef [0000-0001-9958-5683], Jiménez Saiz, Rodrigo [0000-0002-0606-3251], Knol, Edward [0000-0001-7368-9820], Krohn, Kortekaas [0000-0003-3649-1131], Kothari, Akash [0000-0003-1980-161X], Moniuszko, Marcin [0000-0001-7183-3120], Morita, Hideaki [0000-0003-0928-8322], Nadeau, Kari C. [0000-0002-2146-2955], Ozdemir, Cevdet [0000-0002-9284-4520], Pali-Schöll, Isabella [0000-0003-2089-6011], Palomares, O. [0000-0003-4516-0369], Papaleo, Francesco [0000-0002-6326-0657], Prunicki, Mary [0000-0002-5511-8896], Schmidt-Weber, C. B. [0000-0002-3203-8084], Schwarze, Jürgen [0000-0002-6899-748X], Tramper-Stranders, Gerdien [0000-0002-0228-5375], Veen, Willem van de [0000-0001-9951-6688], and Untersmayr, Eva [0000-0002-1963-499X]

Subjects
medicine.medical_specialty, Allergy, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Immunology, Pneumonia, Viral, Eaaci Position Paper, SARS‐CoV‐2 receptors, Disease, medicine.disease_cause, COVID‐19 treatment, 03 medical and health sciences, Betacoronavirus, COVID‐19 prevention, 0302 clinical medicine, Immune system, COVID-19 Testing, Pandemic, medicine, Immunology and Allergy, Humans, Intensive care medicine, Pandemics, Coronavirus, SARS, business.industry, Clinical Laboratory Techniques, SARS-CoV-2, Academies and Institutes, COVID‐19 comorbidity, COVID-19, biochemical phenomena, metabolism, and nutrition, Acquired immune system, medicine.disease, 3. Good health, 030228 respiratory system, COVID‐19 immunity, COVID‐19 multi‐morbidity, business, Coronavirus Infections, 030215 immunology
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 multi‐organ 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., 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.

Published
2020
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2. A compendium answering 150 questions on COVID-19 and SARS-CoV-2

Author

Sebastian L. Johnston, Thomas Eiwegger, Ahmet Kursat Azkur, Jürgen Schwarze, Carmen Riggioni, Zuzana Diamant, Ioana Agache, Willem van de Veen, Milena Sokolowska, Mübeccel Akdis, Cezmi A. Akdis, Heimo Breiteneder, Luo Zhang, Josep M. Antó, María José Torres, Jean Bousquet, Rodrigo Jiménez-Saiz, Mattia Giovannini, Cristina Boccabella, Alessandra Arcolaci, Aspasia Karavelia, Menno C. van Zelm, Oliver Pfaar, Burcin Beken, Marek Sanak, Liam O'Mahony, Daniela Carvalho, Wytske Fokkens, Pasquale Comberiati, Marek Jutel, Kari C. Nadeau, Leticia De las Vecillas, Magna Alves-Correia, Ibon Eguiluz-Gracia, Farah Hannachi, Stefanie Eyerich, Robyn E O'Hehir, Ya dong Gao, Dilek Azkur, Beatriz Moya, De Yun Wang, Ludger Klimek, Consejo Superior de Investigaciones Científicas (España), Ministerio de Economía y Competitividad (España), Instituto de Salud Carlos III, Riggioni, Carmen [0000-0002-8745-0228], Comberiat, Pasquale [0000-0001-5209-9733], Giovannini, Mattia [0000-0001-9568-6882], Agache, Ioana [0000-0001-7994-364X], Akdis, Mubeccel [0000-0003-0554-9943], Alves-Correia, Magna [0000-0002-7676-5558], Antó, Josep M. [0000-0002-4736-8529], Azkur, Ahmet Kursat [0000-0002-5597-8917], Azkur, Dilek [0000-0002-4396-9087], Boccabella, Cristina [0000-0003-1942-8886], Breiteneder, Heimo [0000-0003-2022-8689], Carvalho, Daniela [0000-0002-0432-3339], Vecillas, Leticia de las [0000-0003-4969-5678], Diamant, Zuzana [0000-0003-0133-0100], Eguiluz-Gracia, Ibon [0000-0002-3774-931X], Eiwegger, Thomas [0000-0002-2914-7829], Fokkens, Wytske [0000-0003-4852-229X], Gao, Ya-dong [0000-0003-1251-7608], Nadeau, Kari C. [0000-0002-2146-2955], O'Mahony, Liam [0000-0003-4705-3583], Pfaar, Oliver [0000-0003-4374-9639], Sanak, Marek [0000-0001-7635-8103], Schwarze, Jürgen [0000-0002-6899-748X], Sokolowska, Milena [0000-0001-9710-6685], Torres Jaén, María José [0000-0001-5228-471X], Veen, Willem van de [0000-0001-9951-6688], Zelm, Menno C. van [0000-0003-4161-1919], Wang, De Yun [0000-0002-0909-2963], Zhang, Luo [0000-0002-0910-9884], Jiménez Saiz, Rodrigo [0000-0002-0606-3251], Akdis, Cezmi A. [0000-0001-8020-019X], Riggioni, Carmen, Comberiat, Pasquale, Giovannini, Mattia, Agache, Ioana, Akdis, Mubeccel, Alves-Correia, Magna, Antó, Josep M., Azkur, Ahmet Kursat, Azkur, Dilek, Boccabella, Cristina, Breiteneder, Heimo, Carvalho, Daniela, Vecillas, Leticia de las, Diamant, Zuzana, Eguiluz-Gracia, Ibon, Eiwegger, Thomas, Fokkens, Wytske, Gao, Ya-dong, Nadeau, Kari C., O'Mahony, Liam, Pfaar, Oliver, Sanak, Marek, Schwarze, Jürgen, Sokolowska, Milena, Torres Jaén, María José, Veen, Willem van de, Zelm, Menno C. van, Wang, De Yun, Zhang, Luo, Jiménez Saiz, Rodrigo, and Akdis, Cezmi A.

Subjects
0301 basic medicine, Allergy, AZITHROMYCIN, allergy, coronavirus disease 2019, COVID-19, SARS-CoV-2, severe acute respiratory syndrome–related coronavirus 2, Betacoronavirus, Coronavirus Infections, Humans, Hypersensitivity, Pandemics, Pneumonia, Viral, Disease, Review, SARS‐CoV‐2, 0302 clinical medicine, prevention, Pandemic, Epidemiology, Medicine, Immunology and Allergy, Viral, Coronavirus disease 2019, IMMUNE-RESPONSES, cytokine storm syndrome, severe acute respiratory syndrome‐related coronavirus 2, 1107 Immunology, epidemiology, SPIKE GLYCOPROTEIN, Life Sciences & Biomedicine, SARS-CORONAVIRUS, ANGIOTENSIN-CONVERTING ENZYME, medicine.medical_specialty, TRANSMISSION, Immunology, Reviews, Context (language use), 03 medical and health sciences, Severe acute respiratory syndrome–related coronavirus 2, EPIDEMIC, COVID‐19, LONGITUDINAL PROFILE, severe acute respiratory syndrome-related coronavirus 2, Intensive care medicine, Science & Technology, COVID-19, SARS-CoV-2, allergen immunotherapy, allergy, asthma, coronavirus disease 2019, cytokine storm syndrome, epidemiology, pandemic, prevention, severe acute respiratory syndrome-related coronavirus 2, business.industry, pandemic, Pneumonia, asthma, medicine.disease, KAWASAKI-LIKE DISEASE, Clinical trial, 030104 developmental biology, Clinical research, 030228 respiratory system, Severe acute respiratory syndrome-related coronavirus 2, allergen immunotherapy, business, Cytokine storm, ACUTE RESPIRATORY SYNDROME
Abstract

In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID‐19). This disease, caused by the severe acute respiratory syndrome–related coronavirus 2 (SARS‐CoV‐2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID‐19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence‐based medical advice on SARS‐CoV‐2 and COVID‐19. Although the majority of the patients show a very mild, self‐limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID‐19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a “cytokine storm” leading to acute respiratory distress syndrome, endothelitis, thromboembolic complications, and multiorgan failure. The epidemiologic features of COVID‐19 are distinctive and have changed throughout the pandemic. Vaccine and drug development studies and clinical trials are rapidly growing at an unprecedented speed. However, basic and clinical research on COVID‐19–related topics should be based on more coordinated high‐quality studies. This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19, and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development, and epidemiology. A total of 150 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease., NHMRC Senior Research Fellowship, Grant/ Award Number: GNT1117687; Consejo Superior de Investigaciones Científicas, Grant/Award Number: IJCI-2016-27619; Instituto de Salud Carlos III, Grant/Award Number: JR19/0029

Published
2020
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