ReviewImmunobiology2023
Complement and COVID-19: Three years on, what we know, what we don't know, and what we ought to know.
Review in Immunobiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Parallel electrophysiological abnormalities due to COVID-19 infection and to Alzheimer's disease and related dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Pooled it
- Heterogeneity of Immunological, Coagulation and Complement Clustering to Viral Challenge and Clinical Relevance.International journal of molecular sciences · 2026Article
- The Complement System in the Setting of Critical Illness-A Narrative Review.Biomolecules · 2026Review
- Complement System Dysregulation in the Immunopathogenesis of Long COVID: Systematic Evidence Synthesis.Biomedicines · 2026Review
- C3d Complement Activation and Antibody Immunity in Convalescent COVID-19: Insights From Adults and Children.Journal of immunology research · 2026Article
- The grand escape - how pathogens outsmart the human complement system.Immunobiology · 2025Review
- Relationship Between Cell Surface Viral Glycoprotein Expression and Resistance of Parainfluenza Virus Persistently Infected Cells to Complement-Mediated Lysis.Pathogens (Basel, Switzerland) · 2025Article
- MICBG406A polymorphism reduces risk of mechanical ventilation and death during viral acute lung injury.JCI insight · 2025Article
- Complement Activation is More Pronounced in the Kidneys of Critically Ill Patients With COVID-19 Than in Those With Bacterial Sepsis.Kidney international reports · 2025Article
- Article
- Complex causal relationships between genetic predictions of 731 immune cell phenotypes and novel coronavirus: A two-sample Mendelian randomization analysis.Journal of the Chinese Medical Association : JCMA · 2025Article
- Resistance to complement-mediated lysis of parainfluenza virus 5-infected cells is acquired after transition from acute to persistent infection.Journal of virology · 2025Article
- Single-cell and Spatial Transcriptomics Illuminate Bat Immunity and Barrier Tissue Evolution.Molecular biology and evolution · 2025Article
- Functional mass spectrometry indicates anti-protease and complement activity increase with COVID-19 severity.Experimental biology and medicine (Maywood, N.J.) · 2025Article
- Proteomic signatures of vaccine-induced and breakthrough infection-induced host responses to SARS-CoV-2.Vaccine · 2025Article
- Epidemiological Study in Antiviral Innate Immunity.Methods in molecular biology (Clifton, N.J.) · 2025Article
- Quantitative IgG response to SARS-CoV-2 membrane protein in infected individuals strongly correlates with lung injury.Scientific reports · 2024Article
- Patterns of C1-Inhibitor Plasma Levels and Kinin-Kallikrein System Activation in Relation to COVID-19 Severity.Life (Basel, Switzerland) · 2024Article
- The complement system: A key player in the host response to infections.European journal of immunology · 2024Review
- Immunity and Coagulation in COVID-19.International journal of molecular sciences · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was identified in China in 2019 as the causative agent of COVID-19, and quickly spread throughout the world, causing over 7 million deaths, of which 2 million occurred prior to the introduction of the first vaccine. In the following discussion, while recognising that complement is just one of many players in COVID-19, we focus on the relationship between complement and COVID-19 disease, with limited digression into directly-related areas such as the relationship between complement, kinin release, and coagulation. Prior to the 2019 COVID-19 outbreak, an important role for complement in coronavirus diseases had been established. Subsequently, multiple investigations of patients with COVID-19 confirmed that complement dysregulation is likely to be a major driver of disease pathology, in some, if not all, patients. These data fuelled evaluation of many complement-directed therapeutic agents in small patient cohorts, with claims of significant beneficial effect. As yet, these early results have not been reflected in larger clinical trials, posing questions such as who to treat, appropriate time to treat, duration of treatment, and optimal target for treatment. While significant control of the pandemic has been achieved through a global scientific and medical effort to comprehend the etiology of the disease, through extensive SARS-CoV-2 testing and quarantine measures, through vaccine development, and through improved therapy, possibly aided by attenuation of the dominant strains, it is not yet over. In this review, we summarise complement-relevant literature, emphasise its main conclusions, and formulate a hypothesis for complement involvement in COVID-19. Based on this we make suggestions as to how any future outbreak might be better managed in order to minimise impact on patients.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.