SARS-CoV-2 pathogenesis

Mart M. Lamers, Bart Haagmans*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

364 Citations (Scopus)


The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a devastating pandemic. Although most people infected with SARS-CoV-2 develop a mild to moderate disease with virus replication restricted mainly to the upper airways, some progress to having a life-threatening pneumonia. In this Review, we explore recent clinical and experimental advances regarding SARS-CoV-2 pathophysiology and discuss potential mechanisms behind SARS-CoV-2-associated acute respiratory distress syndrome (ARDS), specifically focusing on new insights obtained using novel technologies such as single-cell omics, organoid infection models and CRISPR screens. We describe how SARS-CoV-2 may infect the lower respiratory tract and cause alveolar damage as a result of dysfunctional immune responses. We discuss how this may lead to the induction of a ‘leaky state’ of both the epithelium and the endothelium, promoting inflammation and coagulation, while an influx of immune cells leads to overexuberant inflammatory responses and immunopathology. Finally, we highlight how these findings may aid the development of new therapeutic interventions against COVID-19.
Original languageEnglish
Pages (from-to)270–284
Number of pages15
JournalNature Reviews Microbiology
Issue number5
Early online date30 Mar 2022
Publication statusPublished - May 2022

Bibliographical note

Series: COVID-19

© Springer Nature Limited 2022


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