Blood Rev . Complement activation in COVID-19 and targeted therapeutic options: A scoping review

[tetano]

Blood Rev


. 2022 Jul 30;100995.
doi: 10.1016/j.blre.2022.100995. Online ahead of print.
Complement activation in COVID-19 and targeted therapeutic options: A scoping review


Endry Hartono Taslim Lim ¹ , Rombout Benjamin Ezra van Amstel ² , Vieve Victoria de Boer ³ , Lonneke Alette van Vught ⁴ , Sanne de Bruin ² , Matthijs Christian Brouwer ⁵ , Alexander Petrus Johannes Vlaar ⁶ , Diederik van de Beek ⁵



Affiliations

• PMID: 35934552
• DOI: 10.1016/j.blre.2022.100995

Abstract

Increasing evidence suggests that activation of the complement system plays a key role in the pathogenesis and disease severity of Coronavirus disease 2019 (COVID-19). We used a systematic approach to create an overview of complement activation in COVID-19 based on histopathological, preclinical, multiomics, observational and clinical interventional studies. A total of 1801 articles from PubMed, EMBASE and Cochrane was screened of which 157 articles were included in this scoping review. Histopathological, preclinical, multiomics and observational studies showed apparent complement activation through all three complement pathways and a correlation with disease severity and mortality. The complement system was targeted at different levels in COVID-19, of which C5 and C5a inhibition seem most promising. Adequately powered, double blind RCTs are necessary in order to further investigate the effect of targeting the complement system in COVID-19.

Keywords: COVID-19; Complement cascade; Complement inhibition; Review; SARS-CoV-2.