Trends in Immunology
Volume 41, Issue 12, December 2020, Pages 1100-1115
Journal home page for Trends in Immunology

Review
Mechanisms of SARS-CoV-2 Transmission and Pathogenesis

https://doi.org/10.1016/j.it.2020.10.004Get rights and content

Highlights

  • The emergence of SARS-CoV-2 from China and the rapidity of a worldwide pandemic has promoted global collaboration, built on a body of work established from previous SARS-CoV and MERS-CoV outbreaks. These past experiences have aided the swiftness by which the research community has responded with an astonishing body of work.

  • SARS-CoV-2 is a novel virus in the Betacoronavirus genus and exhibits similarities to SARS-CoV in genome structure, tissue tropism, and viral pathogenesis. Yet, SARS-CoV-2 appears to be more transmissible and the diversity of immune responses are poorly understood.

  • Highly pathogenic coronaviruses display potent interferon (IFN) antagonism, which is evident in cases of severe COVID-19 with reduced IFN signaling, and an overaggressive immune response compounded by heightened cytokines/chemokines.

  • Animal models for SARS-CoV-2 recapitulate important aspects of human COVID-19 that are essential for evaluating current and prospective antiviral therapeutics and vaccine candidates.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) marks the third highly pathogenic coronavirus to spill over into the human population. SARS-CoV-2 is highly transmissible with a broad tissue tropism that is likely perpetuating the pandemic. However, important questions remain regarding its transmissibility and pathogenesis. In this review, we summarize current SARS-CoV-2 research, with an emphasis on transmission, tissue tropism, viral pathogenesis, and immune antagonism. We further present advances in animal models that are important for understanding the pathogenesis of SARS-CoV-2, vaccine development, and therapeutic testing. When necessary, comparisons are made from studies with SARS to provide further perspectives on coronavirus infectious disease 2019 (COVID-19), as well as draw inferences for future investigations.

Keywords

severe acute respiratory syndrome
coronavirus
COVID-19
SARS, SARS-CoV-2

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2

These authors contributed equally.

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