Cited by 1,623SARS-CoV-2 and COVID-19 ResearchCOVID-19 Clinical Research StudiesImmune responses and vaccinations

Immunology of COVID-19: Current State of the Science

Open access
Vabret, Nicolas, Britton, Graham J., Gruber, Conor, Hegde, Samarth, Kim, Joel, Kuksin, Maria, Levantovsky, Rachel, Malle, Louise +80 more·2020·Immunity

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people worldwide, igniting an unprecedented effort from the scientific community to understand the biological underpinning of COVID19 pathophysiology. In this Review, we summarize the current state of knowledge of innate and adaptive immune responses elicited by SARS-CoV-2 infection and the immunological pathways that likely contribute to disease severity and death. We also discuss the rationale and clinical outcome of current therapeutic strategies as well as prospective clinical trials to prevent or treat SARS-CoV-2 infection.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.immuni.2020.05.002

Cites

333 of 333 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • IL-6 is a major player in chronic inflammatory diseases, autoimmune diseases, cancer and cytokine storm.

    “Among them, IL-6 is a major player in chronic inflammatory diseases, autoimmune diseases, cancer and cytokine storm (1, 3, 10–26).”

    From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [17]

    The Therapeutic Immunomodulation for COVID-19 Treatment section (page unavailable) describes IL-6 as a critical cytokine in COVID-19-associated cytokine release syndrome, supporting the cytokine-storm portion of the claim. The passages found do not establish that IL-6 is a major player in chronic inflammatory diseases, autoimmune diseases, or cancer. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • ARDS in COVID-19 is considered the result of cytokine storm, resembling the disease caused by SARS-CoV-1 and Middle East respiratory syndrome coronavirus.

    “ARDS in COVID-19 is considered the result of cytokine storm (12–17), resembling the disease caused by SARS-CoV-1 and Middle East respiratory syndrome coronavirus (MERS-CoV) (335).”

    From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [17]

  • Severe COVID-19 is a cytokine storm syndrome.

    “Consistent with the notion that severe COVID-19 is a cytokine storm syndrome (12–17, 336), the severity of COVID-19 is associated with an increased level of inflammatory cytokines, such as IL-6, granulocyte macrophage colony-stimulating factor (GM-CSF) and TNFα (333, 337).”

    From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [17]

  • No correlate of protection against COVID-19 or SARS-CoV-2 infection is currently defined, and the immune thresholds needed for vaccine efficacy remain undefined.

    “There is currently no defined correlate of protection against COVID-19 or SARS-CoV-2 infection, and as such the immunological thresholds required for vaccine efficacy have not yet been defined163.”
  • The host appears to be the major factor explaining COVID-19 disease severity, infection rates, and long-term medical consequences.

    “the host itself seems to be the major factor explaining disease severity, infection rates (Merad and Martin, 2020; Vabret et al., 2020), and long-term medical consequences (Marshall, 2020).”

    From COVID-19 and the human innate immune system (2021) · cites this paper as Vabret et al., 2020

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

2 retracted

Flagged first, then by citations

Research works printed but not linked: 29

  1. Bao L. Deng W. Gao H. Xiao C. Liu J. Xue J. Lv Q. Liu J. Yu P. Xu Y. Reinfection could not occur in SARS-CoV-2 infected rhesus macaques bioRxiv 2020 10.1101/2020.03.13.990226 · DOI · Paper page
  2. Campbell K.M. Steiner G. Wells D.K. Ribas A. Kalbasi A. Prediction of SARS-CoV-2 epitopes across 9360 HLA class I alleles bioRxiv 2020 10.1101/2020.03.30.016931 · DOI
  3. Chen L. Liu H.G. Liu W. Liu J. Liu K. Shang J. Deng Y. Wei S. [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia] Zhonghua Jie He He Hu Xi Za Zhi 43 2020 203 208 32164089
  4. Chen X. Zhao B. Qu Y. Chen Y. Xiong J. Feng Y. Men D. Huang Q. Liu Y. Yang B. Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely associated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients Clin. Infect. Dis. 2020 10.1093/cid/ciaa449 Published online April 17, 2020 PMC7184354 32301997 · DOI
  5. Clementi N. Criscuolo E. Diotti R.A. Ferrarese R. Castelli M. Burioni R. Clementi M. Mancini N. Combined prophylactic and therapeutic use maximizes hydroxychloroquine anti-SARS-CoV-2 effects in vitro bioRxiv 2020 10.1101/2020.03.29.014407 PMC7365881 32754147 · DOI
  6. Del Valle D.M. Kim-Schulze S. Hsin-Hui H. Beckmann N.D. Nirenberg S. Wang B. Lavin Y. Swartz T. Madduri D. Stock A. An inflammatory cytokine signature helps predict COVID-19 severity and death medRxiv 2020 10.1101/2020.05.28.20115758 PMC7869028 32839624 · DOI
  7. Díez J.-M. Romero C. Gajardo R. Currently available intravenous immunoglobulin (Gamunex®-C and Flebogamma® DIF) contains antibodies reacting against SARS-CoV-2 antigens bioRxiv 2020 10.1101/2020.04.07.029017 PMC7222542 32397847 · DOI
  8. Guo C. Li B. Ma H. Wang X. Cai P. Yu Q. Zhu L. Jin L. Jiang C. Fang J. Tocilizumab treatment in severe COVID-19 patients attenuates the inflammatory storm incited by monocyte centric immune interactions revealed by single-cell analysis bioRxiv 2020 10.1101/2020.04.08.029769 · DOI
  9. Hulme O.J. Wagenmakers E.-J. Damkier P. Madelung C.F. Siebner H.R. Helweg-Larsen J. Gronau Q. Benfield T.L. Madsen K.H. A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19 medRxiv 2020 10.1101/2020.03.31.20048777 PMC7894854 33606702 · DOI
  10. Konig M.F. Powell M. Staedtke V. Bai R.-Y. Thomas D.L. Fischer N. Huq S. Khalafallah A.M. Koenecke A. Xiong R. Targeting the catecholamine-cytokine axis to prevent SARS-CoV-2 cytokine storm syndrome medRxiv 2020 10.1101/2020.04.02.20051565 PMC7324164 32352407 · DOI
  11. Lei L. Qian H. Yang X. Zhou X. Zhang X. Zhang D. Dai T. Guo R. Shi L. Cheng Y. The phenotypic changes of γδ T cells in COVID-19 patients medRxiv 2020 10.1101/2020.04.05.20046433 PMC7576249 32864865 · DOI
  12. Li K. Chen D. Chen S. Feng Y. Chang C. Wang Z. Wang N. Zhen G. Radiographic Findings and other Predictors in Adults with Covid-19 medRxiv 2020 10.1101/2020.03.23.20041673 PMC7289230 32527255 · DOI
  13. Liu B. Han J. Cheng X. Yu L. Zhang L. Wang W. Ni L. Wei C. Huang Y. Cheng Z. Persistent SARS-CoV-2 presence is companied with defects in adaptive immune system in non-severe COVID-19 patients medRxiv 2020 10.1101/2020.03.26.20044768 PMC7573596 33077873 · DOI
  14. Lokugamage K.G. Hage A. Schindewolf C. Rajsbaum R. Menachery V.D. SARS-CoV-2 is sensitive to type I interferon pretreatment bioRxiv 2020 10.1101/2020.03.07.982264 PMC7654262 32938761 · DOI
  15. Lon J.R. Bai Y. Zhong B. Cai F. Du H. Prediction and Evolution of B Cell Epitopes of Surface Protein in SARS-CoV-2 bioRxiv 2020 10.1101/2020.04.03.022723 PMC7594941 33121513 · DOI
  16. Lou B. Li T. Zheng S. Su Y. Li Z. Liu W. Yu F. Ge S. Zou Q. Yuan Q. Serology characteristics of SARS-CoV-2 infection since the exposure and post symptoms onset medRxiv 2020 10.1101/2020.03.23.20041707 PMC7401320 32430429 · DOI
  17. Lu X. Chen T. Wang Y. Wang J. Zhang B. Li Y. Yan F. Adjuvant corticosteroid therapy for critically ill patients with COVID-19 medRxiv 2020 10.1101/2020.04.07.20056390 PMC7235543 32430057 · DOI
  18. Pan X. Zhou P. Fan T. Wu Y. Zhang J. Shi X. Shang W. Fang L. Jiang X. Shi J. Immunoglobulin fragment F(ab’)2 against RBD potently neutralizes SARS-CoV-2 in vitro bioRxiv 2020 10.1101/2020.04.07.029884 PMC7351055 32659292 · DOI
  19. Pei S. Yuan X. Zhang Z. Yao R. Xie Y. Shen M. Li B. Chen X. Yin M. Convalescent Plasma to Treat COVID-19: Chinese Strategy and Experiences medRxiv 2020 10.1101/2020.04.07.20056440 PMC8034927 33735836 · DOI
  20. Poor H.D. Ventetuolo C.E. Tolbert T. Chun G. Serrao G. Zeidman A. Dangayach N.S. Olin J. Kohli-Seth R. Powell C.A. COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis medRxiv 2020 10.1101/2020.04.17.20057125 PMC7288983 32508062 · DOI
  21. Renieri A. Benetti E. Tita R. Spiga O. Ciolfi A. Birolo G. Bruselles A. Doddato G. Giliberti A. Marconi C. ACE2 variants underlie interindividual variability and susceptibility to COVID-19 in Italian population medRxiv 2020 10.1101/2020.04.03.20047977 PMC7366459 32681121 · DOI
  22. Shamshirian A. Hessami A. Heydari K. Alizadeh-Navaei R. Ebrahimzadeh M.A. Ghasemian R. Aboufazeli E. Baradaran H. Karimifar K. Eftekhari A. Hydroxychloroquine Versus COVID-19: A Rapid Systematic Review and Meta-Analysis medRxiv 2020 10.1101/2020.04.14.20065276 · DOI
  23. Shao Z. Feng Y. Zhong L. Xie Q. Lei M. Liu Z. Wang C. Ji J. Li W. Liu H. Clinical Efficacy of Intravenous Immunoglobulin Therapy in Critical Patients with COVID-19: A multicenter retrospective cohort study medRxiv 2020 10.1101/2020.04.11.20061739 PMC7557105 33082954 · DOI
  24. Wang W. He J. Lie P. Huang L. Wu S. Lin Y. Liu X. The definition and risks of Cytokine Release Syndrome-Like in 11 COVID-19-Infected Pneumonia critically ill patients: Disease Characteristics and Retrospective Analysis medRxiv 2020 10.1101/2020.02.26.20026989 PMC7337810 32601708 · DOI
  25. Xiong R. Zhang L. Li S. Sun Y. Ding M. Wang Y. Zhao Y. Wu Y. Shang W. Jiang X. Novel and potent inhibitors targeting DHODH, a rate-limiting enzyme in de novo pyrimidine biosynthesis, are broad-spectrum antiviral against RNA viruses including newly emerged coronavirus SARS-CoV-2 bioRxiv 2020 10.1101/2020.03.11.983056 PMC7402641 32754890 · DOI
  26. Yan L. Zhang H.-T. Xiao Y. Wang M. Sun C. Liang J. Li S. Zhang M. Guo Y. Xiao Y. Prediction of criticality in patients with severe Covid-19 infection using three clinical features: a machine learning-based prognostic model with clinical data in Wuhan medRxiv 2020 10.1101/2020.02.27.20028027 · DOI
  27. Zhang B. Liu S. Tan T. Huang W. Dong Y. Chen L. Chen Q. Zhang L. Zhong Q. Zhang X. Treatment With Convalescent Plasma for Critically Ill Patients With SARS-CoV-2 Infection Chest 2020 10.1016/j.chest.2020.03.039 Published online March 31, 2020 PMC7195335 32243945 · DOI
  28. Zhang J. Liu J. Li N. Liu Y. Ye R. Qin X. Zheng R. Serological detection of 2019-nCoV respond to the epidemic: A useful complement to nucleic acid testing medRxiv 2020 10.1101/2020.03.04.20030916 PMC7391978 32771946 · DOI
  29. Zhao X. Zheng S. Chen D. Zheng M. Li X. Li G. Lin H. Chang J. Zeng H. Guo J.-T. LY6E Restricts the Entry of Human Coronaviruses, including the currently pandemic SARS-CoV-2 bioRxiv 2020 10.1101/2020.04.02.021469 PMC7459569 32641482 · DOI

Cited by

Sorted by citations

Authors
Vabret, N., Britton, G. J., Gruber, C., Hegde, S., Kim, J., Kuksin, M., Levantovsky, R., Malle, L., Moreira, A., Park, M. D., Pia, L., Risson, E., Saffern, M., Salomé, B., Esai Selvan, M., Spindler, M. P., Tan, J., van der Heide, V., Gregory, J. K., Alexandropoulos, K., Bhardwaj, N., Brown, B. D., Greenbaum, B., Gümüş, Z. H., Homann, D., Horowitz, A., Kamphorst, A. O., Curotto de Lafaille, M. A., Mehandru, S., Merad, M., Samstein, R. M., Agrawal, M., Aleynick, M., Belabed, M., Brown, M., Casanova-Acebes, M., Catalan, J., Centa, M., Charap, A., Chan, A., Chen, S. T., Chung, J., Bozkus, C. C., Cody, E., Cossarini, F., Dalla, E., Fernandez, N., Grout, J., Ruan, D. F., Hamon, P., Humblin, E., Jha, D., Kodysh, J., Leader, A., Lin, M., Lindblad, K., Lozano-Ojalvo, D., Lubitz, G., Magen, A., Mahmood, Z., Martinez-Delgado, G., Mateus-Tique, J., Meritt, E., Moon, C., Noel, J., O’Donnell, T., Ota, M., Plitt, T., Pothula, V., Redes, J., Reyes Torres, I., Roberto, M., Sanchez-Paulete, A. R., Shang, J., Schanoski, A. S., Suprun, M., Tran, M., Vaninov, N., Wilk, C. M., Aguirre-Ghiso, J., Bogunovic, D., Cho, J., Faith, J., Grasset, E., Heeger, P., Kenigsberg, E., Krammer, F., & Laserson, U.
Affiliations
Icahn School of Medicine at Mount Sinai (US)
Corresponding author
  • Vabret, Nicolas
  • Samstein, Robert M.
Venue
Immunity
Publisher
Elsevier BV
Published
2020-06
Volume
52
Issue
6
Pages
910-941
ISSN
1074-7613 (ISSN-L)
OpenAlex
W3022878099
Cited by
1,623
References
333
Citations by year
2026: 34 · 2025: 54 · 2024: 113 · 2023: 160 · 2022: 286 · 2021: 567 · 2020: 406 · 2019: 2 · 2013: 1
FWCI
16.82
Type
journal article
Language
en
Open access
Locations
  • Immunity (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Innate Pharma
  • Burroughs Wellcome Fund
  • Genentech
  • Parker Institute for Cancer Immunotherapy
  • National Cancer Institute
  • Regeneron Pharmaceuticals
  • National Institutes of Health (R01AI081848)
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Keywords
COVID-19 pandemic, SARS-CoV-2, innate immune response, adaptive immune response, disease severity, mortality, immunotherapy, antiviral therapy, clinical trials, pathophysiology
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Animals, Disease Susceptibility, Humans, Immunity, Innate, Immunologic Memory, Inflammation, Lymphocytes, Pneumonia, Viral, Coronavirus Infections, Myeloid Cells, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review