Stroke-induced changes to immune function and their relevance to increased risk of severe COVID-19 disease

Author:

McCulloch Laura1ORCID,Mouat Isobel C1ORCID,South Kieron234ORCID,McColl Barry W5ORCID,Allan Stuart M234ORCID,Smith Craig J346ORCID

Affiliation:

1. Centre for Inflammation Research, University of Edinburgh , Edinburgh , UK

2. Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester , Manchester , UK

3. Lydia Becker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Manchester , UK

4. Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester , Manchester , UK

5. UK Dementia Research Institute, University of Edinburgh , Edinburgh , UK

6. Greater Manchester Comprehensive Stroke Centre, Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust , Salford , UK

Abstract

Abstract As the COVID-19 pandemic moves towards endemic disease, it remains of key importance to identify groups of individuals vulnerable to severe infection and understand the biological factors that mediate this risk. Stroke patients are at increased risk of developing severe COVID-19, likely due to stroke-induced alterations to systemic immune function. Furthermore, immune responses associated with severe COVID-19 in patients without a history of stroke parallel many of the immune alterations induced by stroke, possibly resulting in a compounding effect that contributes to worsened disease severity. In this review, we discuss the changes to systemic immune function that likely contribute to augmented COVID-19 severity in patients with a history of stroke and the effects of COVID-19 on the immune system that may exacerbate these effects.

Funder

Medical Research Council

Wellcome Sir Henry Dale Fellow

Medical Research Foundation

Leducq Foundation Transatlantic Network of Excellence, Stroke-IMPaCT

UK Dementia Research Institute

Alzheimer’s Society

Alzheimer’s Research UK

Publisher

Oxford University Press (OUP)

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