• Paola de Candia, Francesco Prattichizzo, Silvia Garavelli, and Giuseppe Matarese.
• IRCCS MultiMedica, Milano, Italy. Electronic address: paola.decandia@multimedica.it.
• Trends Immunol. 2021 Jan 1; 42 (1): 18-30.

AbstractSevere infection with severe acute respiratory syndrome coronavirus (SARS-CoV)-2 is characterized by massive cytokine release and T cell loss. The exaggerated host immune response, incapable of viral clearance, instead aggravates respiratory distress, as well as cardiac, and/or damage to other organs. The mortality pattern of SARS-CoV-2 infection, higher in older versus younger adults and almost absent in children, is possibly caused by the effects of age and pre-existing comorbidities on innate and adaptive immunity. Here, we speculate that the abnormal and excessive immune response to SARS-CoV-2 infection partly depends on T cell immunological memory, which is more pronounced in adults compared with children, and may significantly contribute to immunopathology and massive collateral damage in coronavirus disease 2019 (COVID-19) patients.Copyright © 2020 Elsevier Ltd. All rights reserved.

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