The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity—a systematic review - Report - MDSpire

The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity—a systematic review

  • By

  • Harika Öykü Dinç

  • Suat Saribaş

  • Bekir Kocazeybek

  • June 10, 2026

  • 0 min

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Clinical Report: Exploring the Immunopathological Landscape of COVID-19

Overview

This systematic review evaluates the immunopathological mechanisms of COVID-19, highlighting the roles of cytokine storms, endothelial dysfunction, and autoimmune responses. Key findings indicate that these mechanisms significantly contribute to disease severity and mortality.

Background

COVID-19, caused by SARS-CoV-2, has emerged as a global health crisis with complex immunopathological features. Understanding the immune response is crucial, as dysregulated immune activation can lead to severe tissue damage and multi-organ failure. This review aims to elucidate the interconnected mechanisms that drive COVID-19 pathogenesis.

Data Highlights

MechanismPrevalence
Endothelial dysfunction24.5%
Cytokine dysregulation18.9%
Autoimmune responses15.1%
Complement activation17%

Key Findings

  • Endothelial dysfunction and cytokine dysregulation are the most frequently reported mechanisms in COVID-19.
  • Elevated proinflammatory cytokines and lymphopenia correlate with increased disease severity and mortality.
  • Autoimmune responses and persistent immunological alterations were observed in a subset of post-COVID patients.
  • Complement activation plays a significant role in the inflammatory response during COVID-19.
  • Hyperinflammation is a key determinant of clinical outcomes in severe COVID-19 cases.

Clinical Implications

The findings emphasize the need for targeted immunomodulatory strategies in managing COVID-19. Clinicians should be aware of the potential for autoimmune responses and persistent immunological changes in patients recovering from COVID-19.

Conclusion

COVID-19 pathogenesis is driven by complex immunopathological mechanisms that extend beyond viral effects. Understanding these processes is essential for developing effective therapeutic strategies.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Frontiers in Epidemiology, 2026 -- In-Hospital Cardiovascular Outcomes of COVID-19-Associated Cytokine Storm: A Population-Level Study
  3. Intensive Care Medicine, 2021 -- Autoimmunity Linked to COVID-19 as a Characteristic of Severe Respiratory Distress
  4. The Journal of Infectious Diseases -- Cytokine Profiles Distinguish Acute and Recovery Phases of Cardiac Involvement Following COVID-19: A Multicohort Biomarker Analysis
  5. WHO, 2025 -- Therapeutics and COVID-19: living guideline, August 2025
  6. Cellular and Molecular Mechanisms of SARS-CoV-2 Spike Protein-Induced Endothelial Dysfunction
  7. Association between COVID-19 and New-Onset Autoimmune Diseases: Updated Systematic Review and Meta-Analysis
  8. Therapeutics and COVID-19: living guideline, August 2025

Original Source(s)

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