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COVID-19 age-dependent immunology and clinical outcomes: implications for vaccines

Published online by Cambridge University Press:  21 July 2021

Azza Sarfraz
Affiliation:
Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Saman Hasan Siddiqui
Affiliation:
Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Junaid Iqbal
Affiliation:
Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
Syed Asad Ali
Affiliation:
Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Zahra Hasan
Affiliation:
Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
Zouina Sarfraz
Affiliation:
Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan
Najeeha Talat Iqbal*
Affiliation:
Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
*
Address for correspondence: Najeeha Talat Iqbal, Associate Professor, Department of Pediatrics and Child Health, Faculty Office Building, Aga Khan University, P.O Box 3500 Stadium Road, Karachi74800, Pakistan. Email: [email protected]

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to acute respiratory distress syndrome (ARDS). Understanding the evolution of the virus, and immune-pathogenic processes are critical for designing future therapeutic interventions. In this review, we collate information on the structure, genome, viral life cycle, and adult and pediatric host immune responses in response to SARS-CoV-2. The immunological responses are a prototype of the developmental origins of health and disease (DOHaD) hypothesis to explain the socio-geographic differences impacting the severity and mortality rates in SARS-CoV-2 infections. The DOHaD hypothesis identifies the relevance of trained innate immunity, age groups, and geography for effective vaccinations. As COVID-19 vaccines are being rolled out, it may be pertinent to assess population-based immunological responses to understand the effectiveness and safety across different populations and age groups.

Type
Review
Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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References

WHO. Events as They Happen. Rolling Updates on Coronavirus Disease (COVID-19), 2020. WHO, Geneva, Switzerland.Google Scholar
Guan, Y, Zheng, BJ, He, YQ, et al. Isolation and characterization of viruses related to the SARS coronavirus from animals in Southern China. Science (80-) 2003; 302, 276278.CrossRefGoogle Scholar
Alagaili, AN, Briese, T, Mishra, N, et al. Middle east respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia. MBio. 2014; 5, e00884–14.Google ScholarPubMed
Lam, TT-Y, Shum, MH-H, Zhu, H-C, et al. Identification of 2019-nCoV related coronaviruses in Malayan pangolins in southern China [Internet]. bioRxiv. 2020. 2020.02.13.945485. Available from: http://biorxiv.org/content/early/2020/02/18/2020.02.13.945485.abstract%0Ahttps://www.biorxiv.org/content/10.1101/2020.02.13.945485v1M Google Scholar
Martorell, R. Improved nutrition in the first 1000 days and adult human capital and health. Am J Hum Biol. 2017; 29, e22952.CrossRefGoogle ScholarPubMed
Maggini, S, Pierre, A, Calder, PC. Immune function and micronutrient requirements change over the life course. Nutrients. 2018; 10, 1531.CrossRefGoogle ScholarPubMed
MacGillivray, DM, Kollmann, TR. The role of environmental factors in modulating immune responses in early life. Front Immunol. 2014; 5, 434.CrossRefGoogle ScholarPubMed
Gorbalenya, AE, Enjuanes, L, Ziebuhr, J, Snijder, EJ. Nidovirales: evolving the largest RNA virus genome. Virus Res. 2006; 117, 1737.CrossRefGoogle ScholarPubMed
Khailany, RA, Safdar, M, Ozaslan, M. Genomic characterization of a novel SARS-CoV-2. Gene Rep. 2020; 19, 100682.CrossRefGoogle ScholarPubMed
Masters, PS, Kuo, L, Ye, R, Hurst, KR, Koetzner, CA, Hsue, B. Genetic and molecular biological analysis of protein-protein interactions in coronavirus assembly. Adv Exp Med Biol. 2006; 581, 163173.CrossRefGoogle ScholarPubMed
Siu, YL, Teoh, KT, Lo, J, et al. The M, E, and N structural proteins of the severe acute respiratory syndrome coronavirus are required for efficient assembly, trafficking, and release of virus-like particles. J Virol. 2008; 82, 1131811330.CrossRefGoogle Scholar
Montecino-Rodriguez, E, Berent-Maoz, B, Dorshkind, K. Causes, consequences, and reversal of immune system aging. J Clin Invest. 2013; 123, 958965.CrossRefGoogle ScholarPubMed
Akira, S, Uematsu, S, Takeuchi, O. Pathogen recognition and innate immunity. Cell. 2006; 124, 783801.CrossRefGoogle ScholarPubMed
Guo, YR, Cao, QD, Hong, ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak- A n update on the status. Mil Med Res. 2020; 7, 11.Google Scholar
Hato, T, Dagher, PC. How the innate immune system senses trouble and causes trouble. Clin J Am Soc Nephrol. 2015;10, 14591469.CrossRefGoogle ScholarPubMed
Duque, GA, Descoteaux, A. Macrophage cytokines: involvement in immunity and infectious diseases. Front Immunol. 2014; 5, 491.Google Scholar
Simon, AK, Hollander, GA, McMichael, A. Evolution of the immune system in humans from infancy to old age. Proc R Soc B: Biol Sci. 2015; 282, 20143085.CrossRefGoogle ScholarPubMed
Förster-Waldl, E, Sadeghi, K, Tamandl, D, et al. Monocyte toll-like receptor 4 expression and LPS-induced cytokine production increase during gestational aging. Pediatr Res. 2005; 58, 121124.CrossRefGoogle ScholarPubMed
De Kleer, I, Willems, F, Lambrecht, B, Goriely, S. Ontogeny of myeloid cells. Front Immunol. 2014; 5, 423.CrossRefGoogle ScholarPubMed
Ivarsson, MA, Loh, L, Marquardt, N, et al. Differentiation and functional regulation of human fetal NK cells. J Clin Invest. 2013; 123, 38893901.CrossRefGoogle ScholarPubMed
Mathew, D, Giles, JR, Baxter, AE, et al. Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications. Science (80-) [Internet]. 2020; eabc8511. Available from: http://science.sciencemag.org/content/early/2020/07/15/science.abc8511.abstract CrossRefGoogle ScholarPubMed
Jiang, L, Tang, K, Levin, M, et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis [Internet]. 2020. doi: 10.1016/S1473-3099(20)30651-4.CrossRefGoogle ScholarPubMed
Onouchi, Y, Gunji, T, Burns, JC, et al. ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms. Nat Genet. 2008; 40, 3542.CrossRefGoogle ScholarPubMed
Huang, C, Wang, Y, Li, X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395, 497506.CrossRefGoogle ScholarPubMed
Zhang, B, Zhou, X, Qiu, Y, et al. Clinical characteristics of 82 death cases with COVID-19. medRxiv [Internet]. 2020; 2020.02.26.20028191. Available from: http://medrxiv.org/content/early/2020/02/27/2020.02.26.20028191.abstract Google Scholar
Xu, Z, Shi, L, Wang, Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8: 420422.CrossRefGoogle ScholarPubMed
Crotty, S. T Follicular Helper cell biology: a decade of discovery and diseases. Immunity. 2019; 50, 11321148.CrossRefGoogle ScholarPubMed
Bolles, M, Deming, D, Long, K, et al. A double-inactivated severe acute respiratory syndrome Coronavirus vaccine provides incomplete protection in Mice and induces increased eosinophilic proinflammatory pulmonary response upon challenge. J Virol. 2011; 85: 1220112215.CrossRefGoogle ScholarPubMed
Long, QX, Liu, BZ, Deng, HJ, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020; 26: 845848.CrossRefGoogle ScholarPubMed
Guo, L, Ren, L, Yang, S, et al. Profiling early humoral response to diagnose novel Coronavirus disease (COVID-19). Clin Infect Dis. 2020; 71, 778785.CrossRefGoogle Scholar
Zhao, J, Yuan, Q, Wang, H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis. 2020; 71, 20272034.CrossRefGoogle ScholarPubMed
Long, QX, Tang, XJ, Shi, QL, et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med [Internet]. 2020; 26, 12001204. Available from: http://www.nature.com/articles/s41591-020-0965-6 CrossRefGoogle ScholarPubMed
Wu, F, Wang, A, Liu, M, et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. SSRN Electron J. 2020.Google Scholar
Long, Q, Deng, H, Chen, J, et al. Antibody responses to SARS-CoV-2 in COVID-19 patients: the perspective application of serological tests in clinical practice. medRxiv. 2020; 2020.03.18.20038018.Google Scholar
Burton, DR, Walker, LM. Rational vaccine design in the time of COVID-19. Cell Host Microbe. 2020; 27, 695698.CrossRefGoogle ScholarPubMed
Joyner, MJ, Wright, RS, Fairweather, D, et al. Early safety indicators of COVID-19 convalescent plasma in 5000 patients. J Clin Invest. 2020; 130, 47914797.CrossRefGoogle ScholarPubMed
Theel, ES, Slev, P, Wheeler, S, Couturier, MR, Wong, SJ, Kadkhoda, K. The role of antibody testing for SARS-CoV-2: is there one? J Clin Microbiol. 2020; 58, e00797–20.CrossRefGoogle Scholar
Park, WB, Kwon, NJ, Choi, SJ, et al. Virus isolation from the first patient with SARS-CoV-2 in Korea. J Korean Med Sci. 2020; 35, e84.CrossRefGoogle ScholarPubMed
Yang, M. Cell pyroptosis, a potential pathogenic mechanism of 2019-nCoV infection. SSRN Electron J. 2020.Google Scholar
Tay, MZ, Poh, CM, Rénia, L, MacAry, PA, Ng, LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20, 363374.CrossRefGoogle ScholarPubMed
Chen, T, Wu, D, Chen, H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020; 368, m1295.Google ScholarPubMed
Wang, D, Hu, B, Hu, C, et al. Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-infected pneumonia in Wuhan, China. JAMA – J Am Med Assoc. 2020; 323, 10611069.CrossRefGoogle ScholarPubMed
Zhou, F, Yu, T, Du, R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395, 10541062.CrossRefGoogle ScholarPubMed
Du, RH, Liang, LR, Yang, CQ, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARSCoV- 2: a prospective cohort study. Eur Respir J. 2020; 55, 2000524.CrossRefGoogle Scholar
Pirofski, LA, Casadevall, A. Pathogenesis of covid-19 from the perspective of the damage-response framework. mBio. 2020; 11, e01175–20.CrossRefGoogle ScholarPubMed
Whittaker, E, Bamford, A, Kenny, J, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA – J Am Med Assoc. 2020; 324, 259269.CrossRefGoogle ScholarPubMed
Center for Disease Control and Prevention. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19) [Internet]. [cited 2020 Aug 15]. Available from: https://emergency.cdc.gov/han/2020/han00432.asp Google Scholar
Götzinger, F, Santiago-García, B, Noguera-Julián, A, et al. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020; 4, 653661.CrossRefGoogle ScholarPubMed
Xafis, V, Schaefer, GO, Labude, MK, Zhu, Y, Hsu, LY. The perfect moral storm: diverse ethical considerations in the COVID-19 pandemic. Asian Bioeth Rev [Internet]. 2020; 12, 6583. doi: 10.1007/s41649-020-00125-3.CrossRefGoogle ScholarPubMed
Heindel, JJ, Vandenberg, LN. Developmental origins of health and disease: a paradigm for understanding disease cause and prevention. Curr Opin Pediatr [Internet]. 2015; 27, 248253. Available from: https://pubmed.ncbi.nlm.nih.gov/25635586 CrossRefGoogle ScholarPubMed
Seow, J, Graham, C, Merrick, B, et al. Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans. Nat Microbiol [Internet]. 2020; 5, 15981607. doi: 10.1038/s41564-020-00813-8.CrossRefGoogle ScholarPubMed
Le Bert, N, Tan, AT, Kunasegaran, K, et al. SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls. Nature [Internet]. 2020; 584, 457462. doi: 10.1038/s41586-020-2550-z.CrossRefGoogle ScholarPubMed
Jeyanathan, M, Afkhami, S, Smaill, F, Miller, MS, Lichty, BD, Xing, Z. Immunological considerations for COVID-19 vaccine strategies. Nat Rev Immunol. 2020; 20, 615632.CrossRefGoogle ScholarPubMed
CDC. Different COVID-19 Vaccines [Internet]. 2021 [cited 2021 Mar 23]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html Google Scholar
Jiang, S, Hillyer, C, Du, L. Neutralizing antibodies against SARS-CoV-2 and other human Coronaviruses. Trends Immunol. 2020; 41, 355359.CrossRefGoogle ScholarPubMed