Cited by 2,472COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 ResearchImmune cells in cancer

Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages

Open access
Merad, Miriam, Martin, Jerome C.·2020·Nature Reviews Immunology

Abstract

The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease severity and death in infected patients. Macrophages are a population of innate immune cells that sense and respond to microbial threats by producing inflammatory molecules that eliminate pathogens and promote tissue repair. However, a dysregulated macrophage response can be damaging to the host, as is seen in the macrophage activation syndrome induced by severe infections, including in infections with the related virus SARS-CoV. Here we describe the potentially pathological roles of macrophages during SARS-CoV-2 infection and discuss ongoing and prospective therapeutic strategies to modulate macrophage activation in patients with COVID-19.

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  • 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 Merad and Martin, 2020

  • IL-6 and TNFα can promote vascular permeability, systemic shock and multi-organ failure.

    “Cytokines that mediate manifestations of ARDS, like IL-6 and TNFα, can also facilitate vascular permeability, systemic shock and multi-organ failure41,51.”

    From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [41]

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  1. [22]Gritti, G. et al. Use of siltuximab in patients with COVID-19 pneumonia requiring ventilatory support. Preprint at medRxiv10.1101/2020.04.01.20048561 (2020).

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Authors
Merad, M., & Martin, J. C.
Affiliations
Inserm (FR)
Corresponding author
Martin, Jerome C.
Venue
Nature Reviews Immunology
Published
2020-05-06
Volume
20
Issue
6
Pages
355-362
ISSN
  • 1474-1733 (ISSN-L)
  • 1474-1741
OpenAlex
W3023982717
Cited by
2,472
References
65
Citations by year
2026: 89 · 2025: 133 · 2024: 196 · 2023: 330 · 2022: 529 · 2021: 753 · 2020: 435 · 2019: 2 · 2018: 3
FWCI
24.29
Type
journal article
Language
en
Open access
Locations
  • Nature reviews. Immunology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Funders
  • Icahn School of Medicine at Mount Sinai
  • Agence Nationale de la Recherche (ANR-16-IDEX-0007)
  • Institut National de la Santé et de la Recherche Médicale
  • Université de Nantes
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
Keywords
COVID-19 pandemic, SARS-CoV-2, monocytes, macrophages, hyperinflammation, macrophage activation syndrome, innate immunity, inflammatory signaling
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Animals, Humans, Inflammation, Macrophage Activation, Macrophages, Monocytes, Pneumonia, Viral, Coronavirus Infections, Pandemics

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