Reviews and feature articles
Eosinophil responses during COVID-19 infections and coronavirus vaccination

https://doi.org/10.1016/j.jaci.2020.04.021Get rights and content

Eosinophils are circulating and tissue-resident leukocytes that have potent proinflammatory effects in a number of diseases. Recently, eosinophils have been shown to have various other functions, including immunoregulation and antiviral activity. Eosinophil levels vary dramatically in a number of clinical settings, especially following eosinophil-targeted therapy, which is now available to selectively deplete these cells. There are key coronavirus disease 2019 (COVID-19)-related questions concerning eosinophils whose answers affect recommended prevention and care. First, do patients with eosinophilia-associated diseases have an altered course of COVID-19? Second, do patients with eosinopenia (now intentionally induced by biological drugs) have unique COVID-19 susceptibility and/or disease course? This is a particularly relevant question because eosinopenia is associated with acute respiratory deterioration during infection with the severe acute respiratory syndrome coronavirus 2, the causative agent of COVID-19. Third, do eosinophils contribute to the lung pathology induced during COVID-19 and will they contribute to immunopotentiation potentially associated with emerging COVID-19 vaccines? Herein, we address these timely questions and project considerations during the emerging COVID-19 pandemic.

Key words

Coronavirus
COVID-19
eosinophils
immunopathology
immunopotentiation
SARS
vaccines

Abbreviations used

COVID-19
Coronavirus disease 2019
RSV
Respiratory syncytial virus
S protein
Spike protein
SARS-CoV-1
Severe acute respiratory syndrome coronavirus 1
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
TLR
Toll-like receptor

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Disclosure of potential conflict of interest: M. E. Rothenberg is a consultant for Pulm One, Spoon Guru, ClostraBio, Serpin Pharm, Celgene, Astra Zeneca, Allakos, Arena Pharmaceuticals, Guidepoint, Suvretta, and Capital Management; has an equity interest in the first 4 listed; receives royalties from reslizumab (Teva Pharmaceuticals), PEESSv2 (Mapi Research Trust), and UpToDate; and is an inventor of patents owned by Cincinnati Children’s Hospital. The rest of the authors declare that they have no relevant conflicts of interest.

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