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COVID-19

Coronaviruses hijack the complement system

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Complement activation occurs in patients infected with MERS-CoV, SARS-CoV-1 and SARS-CoV-2, which might be involved in the pathogenesis of acute lung injury and acute respiratory distress syndrome (ARDS). In this preprint, Gao et al. identify the host complement activator MASP2 as a target of the N protein of all three viruses. In mice, lung injury induced by SARS-CoV-1 or MERS-CoV N protein was attenuated when its MASP2-binding motif was altered, when MASP2 was genetically knocked out or when the MASP2–N protein interaction was pharmacologically blocked. Preliminary data from patients treated with a blocking antibody to complement component C5a suggest a potential benefit of targeting complement in patients with COVID-19 with severe lung injury.

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  1. Gao, T. et al. Highly pathogenic coronavirus N protein aggravates lung injury by MASP-2-mediated complement over-activation. Preprint at medRxiv https://doi.org/10.1101/2020.03.29.20041962 (2020)

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Correspondence to C. Matthias Wilk.

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The author declares no competing interests.

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Wilk, C.M. Coronaviruses hijack the complement system. Nat Rev Immunol 20, 350 (2020). https://doi.org/10.1038/s41577-020-0314-5

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