PATHWAY: ko05171 Help
Entry
Name
Coronavirus disease - COVID-19
Description
Coronavirus disease of 2019 (COVID-19) is a highly contagious respiratory infection that is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infects alveolar epithelial cells [mainly alveolar epithelial type 2 (AEC2) cells] through the angiotensin-converting enzyme 2 (ACE2) receptor. Upon the occupancy of ACE2 by SARS-CoV-2, the increased serum level of free Angiotensin II (Ang II) due to a reduction of ACE2-mediated degradation promotes activation of the NF-kappa B pathway via Ang II type 1 receptor (AT1R), followed by interleukin-6 (IL-6) production. SARS-CoV-2 also activates the innate immune system; macrophage stimulation triggers the overproduction of pro-inflammatory cytokines, including IL-6, and the "cytokine storm", which results in systemic inflammatory response syndrome and multiple organ failure. The combined effects of complement activation, dysregulated neutrophilia, endothelial injury, and hypercoagulability appear to be intertwined to drive the severe features of COVID-19.
Class
Human Diseases; Infectious disease: viral
BRITE hierarchy
Pathway map
ko05171 Coronavirus disease - COVID-19
Disease
Drug
D03506 Cinanserin hydrochloride (USAN)
D11943 Molnupiravir (JAN/USAN)
D12115 COVID-19 vaccine (ChAdOx1-S [recombinant])
D12129 COVID-19 vaccine (Ad26.COV2-S [recombinant])
D12142 Casirivimab and imdevimab
D12244 Nirmatrelvir (JAN/USAN)
D12260 Bemnifosbuvir sulfate (USAN)
D12336 SARS-CoV-2 Spike glycoprotein vaccine antigen nvx-cov2373
D12353 Ensitrelvir fumarate (USAN)
D12389 Adintrevimab (USAN/INN)
D12778 Olgotrelvir sodium (USAN)
Orthology
K00922 PIK3CA_B_D; phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha/beta/delta [EC:2.7.1.153 ]
K01116 PLCG1; phosphatidylinositol phospholipase C, gamma-1 [EC:3.1.4.11 ]
K01388 MMP1; matrix metalloproteinase-1 (interstitial collagenase) [EC:3.4.24.7 ]
K01394 MMP3; matrix metalloproteinase-3 (stromelysin 1, progelatinase) [EC:3.4.24.17 ]
K02580 NFKB1; nuclear factor NF-kappa-B p105 subunit
K02581 NFKBIB; NF-kappa-B inhibitor beta
K02649 PIK3R1_2_3; phosphoinositide-3-kinase regulatory subunit alpha/beta/delta
K02865 RP-L10Ae, RPL10A; large subunit ribosomal protein L10Ae
K02866 RP-L10e, RPL10; large subunit ribosomal protein L10e
K02868 RP-L11e, RPL11; large subunit ribosomal protein L11e
K02870 RP-L12e, RPL12; large subunit ribosomal protein L12e
K02872 RP-L13Ae, RPL13A; large subunit ribosomal protein L13Ae
K02873 RP-L13e, RPL13; large subunit ribosomal protein L13e
K02875 RP-L14e, RPL14; large subunit ribosomal protein L14e
K02877 RP-L15e, RPL15; large subunit ribosomal protein L15e
K02880 RP-L17e, RPL17; large subunit ribosomal protein L17e
K02882 RP-L18Ae, RPL18A; large subunit ribosomal protein L18Ae
K02883 RP-L18e, RPL18; large subunit ribosomal protein L18e
K02885 RP-L19e, RPL19; large subunit ribosomal protein L19e
K02889 RP-L21e, RPL21; large subunit ribosomal protein L21e
K02891 RP-L22e, RPL22; large subunit ribosomal protein L22e
K02893 RP-L23Ae, RPL23A; large subunit ribosomal protein L23Ae
K02894 RP-L23e, RPL23; large subunit ribosomal protein L23e
K02896 RP-L24e, RPL24; large subunit ribosomal protein L24e
K02898 RP-L26e, RPL26; large subunit ribosomal protein L26e
K02900 RP-L27Ae, RPL27A; large subunit ribosomal protein L27Ae
K02901 RP-L27e, RPL27; large subunit ribosomal protein L27e
K02903 RP-L28e, RPL28; large subunit ribosomal protein L28e
K02905 RP-L29e, RPL29; large subunit ribosomal protein L29e
K02908 RP-L30e, RPL30; large subunit ribosomal protein L30e
K02910 RP-L31e, RPL31; large subunit ribosomal protein L31e
K02912 RP-L32e, RPL32; large subunit ribosomal protein L32e
K02915 RP-L34e, RPL34; large subunit ribosomal protein L34e
K02917 RP-L35Ae, RPL35A; large subunit ribosomal protein L35Ae
K02918 RP-L35e, RPL35; large subunit ribosomal protein L35e
K02920 RP-L36e, RPL36; large subunit ribosomal protein L36e
K02921 RP-L37Ae, RPL37A; large subunit ribosomal protein L37Ae
K02922 RP-L37e, RPL37; large subunit ribosomal protein L37e
K02923 RP-L38e, RPL38; large subunit ribosomal protein L38e
K02924 RP-L39e, RPL39; large subunit ribosomal protein L39e
K02925 RP-L3e, RPL3; large subunit ribosomal protein L3e
K02927 RP-L40e, RPL40, UBA52; ubiquitin-large subunit ribosomal protein L40e
K02928 RP-L41e, RPL41; large subunit ribosomal protein L41e
K02929 RP-L44e, RPL44; large subunit ribosomal protein L44e
K02930 RP-L4e, RPL4; large subunit ribosomal protein L4e
K02932 RP-L5e, RPL5; large subunit ribosomal protein L5e
K02934 RP-L6e, RPL6; large subunit ribosomal protein L6e
K02936 RP-L7Ae, RPL7A; large subunit ribosomal protein L7Ae
K02937 RP-L7e, RPL7; large subunit ribosomal protein L7e
K02938 RP-L8e, RPL8; large subunit ribosomal protein L8e
K02940 RP-L9e, RPL9; large subunit ribosomal protein L9e
K02941 RP-LP0, RPLP0; large subunit ribosomal protein LP0
K02942 RP-LP1, RPLP1; large subunit ribosomal protein LP1
K02943 RP-LP2, RPLP2; large subunit ribosomal protein LP2
K02947 RP-S10e, RPS10; small subunit ribosomal protein S10e
K02949 RP-S11e, RPS11; small subunit ribosomal protein S11e
K02951 RP-S12e, RPS12; small subunit ribosomal protein S12e
K02953 RP-S13e, RPS13; small subunit ribosomal protein S13e
K02955 RP-S14e, RPS14; small subunit ribosomal protein S14e
K02957 RP-S15Ae, RPS15A; small subunit ribosomal protein S15Ae
K02958 RP-S15e, RPS15; small subunit ribosomal protein S15e
K02960 RP-S16e, RPS16; small subunit ribosomal protein S16e
K02962 RP-S17e, RPS17; small subunit ribosomal protein S17e
K02964 RP-S18e, RPS18; small subunit ribosomal protein S18e
K02966 RP-S19e, RPS19; small subunit ribosomal protein S19e
K02969 RP-S20e, RPS20; small subunit ribosomal protein S20e
K02971 RP-S21e, RPS21; small subunit ribosomal protein S21e
K02973 RP-S23e, RPS23; small subunit ribosomal protein S23e
K02974 RP-S24e, RPS24; small subunit ribosomal protein S24e
K02975 RP-S25e, RPS25; small subunit ribosomal protein S25e
K02976 RP-S26e, RPS26; small subunit ribosomal protein S26e
K02977 RP-S27Ae, RPS27A, UBA80; ubiquitin-small subunit ribosomal protein S27Ae
K02978 RP-S27e, RPS27; small subunit ribosomal protein S27e
K02979 RP-S28e, RPS28; small subunit ribosomal protein S28e
K02980 RP-S29e, RPS29; small subunit ribosomal protein S29e
K02981 RP-S2e, RPS2; small subunit ribosomal protein S2e
K02983 RP-S30e, RPS30; small subunit ribosomal protein S30e
K02984 RP-S3Ae, RPS3A; small subunit ribosomal protein S3Ae
K02985 RP-S3e, RPS3; small subunit ribosomal protein S3e
K02987 RP-S4e, RPS4; small subunit ribosomal protein S4e
K02989 RP-S5e, RPS5; small subunit ribosomal protein S5e
K02991 RP-S6e, RPS6; small subunit ribosomal protein S6e
K02993 RP-S7e, RPS7; small subunit ribosomal protein S7e
K02995 RP-S8e, RPS8; small subunit ribosomal protein S8e
K02997 RP-S9e, RPS9; small subunit ribosomal protein S9e
K02998 RP-SAe, RPSA; small subunit ribosomal protein SAe
K03156 TNF, TNFA; tumor necrosis factor superfamily, member 2
K03158 TNFRSF1A, TNFR1, CD120a; tumor necrosis factor receptor superfamily member 1A
K03174 TRAF3; TNF receptor-associated factor 3
K03900 VWF; von Willebrand factor
K03903 FGA; fibrinogen alpha chain
K03904 FGB; fibrinogen beta chain
K03905 FGG; fibrinogen gamma chain
K03906 F13B; coagulation factor XIII B polypeptide
K03986 C1QA; complement C1q subcomponent subunit A
K03987 C1QB; complement C1q subcomponent subunit B
K03988 C1QG; complement C1q subcomponent subunit C
K03989 C4; complement component 4
K03990 C3; complement component 3
K03991 MBL; mannose-binding lectin
K03992 MASP1; mannan-binding lectin serine protease 1 [EC:3.4.21.-]
K03994 C5; complement component 5
K03995 C6; complement component 6
K03996 C7; complement component 7
K03997 C8A; complement component 8 subunit alpha
K03998 C8B; complement component 8 subunit beta
K03999 C8G; complement component 8 subunit gamma
K04000 C9; complement component 9
K04009 C3AR1; C3a anaphylatoxin chemotactic receptor
K04010 C5AR1, CD88; C5a anaphylatoxin chemotactic receptor 1
K04166 AGTR1; angiotensin II receptor type 1
K04303 MAS1; proto-oncogene Mas
K04379 FOS; proto-oncogene protein c-fos
K04404 MAP3K7IP2, TAB2; TAK1-binding protein 2
K04427 MAP3K7, TAK1; mitogen-activated protein kinase kinase kinase 7 [EC:2.7.11.25 ]
K04440 JNK; mitogen-activated protein kinase 8/9/10 (c-Jun N-terminal kinase) [EC:2.7.11.24 ]
K04448 JUN; transcription factor AP-1
K04467 IKBKA, IKKA, CHUK; inhibitor of nuclear factor kappa-B kinase subunit alpha [EC:2.7.11.10 ]
K04519 IL1B; interleukin 1 beta
K04692 STAT3; signal transducer and activator of transcription 3
K04693 IRF9, ISGF3G, P48; interferon regulatory factor 9
K04729 MYD88; myeloid differentiation primary response protein MyD88
K04730 IRAK1; interleukin-1 receptor-associated kinase 1 [EC:2.7.11.1 ]
K04733 IRAK4; interleukin-1 receptor-associated kinase 4 [EC:2.7.11.1 ]
K04734 NFKBIA; NF-kappa-B inhibitor alpha
K04735 RELA; transcription factor p65
K05055 IL6R, CD126; interleukin 6 receptor
K05060 IL6ST, GP130, CD130; interleukin 6 signal transducer
K05130 IFNAR1; interferon receptor 1
K05131 IFNAR2; interferon receptor 2
K05401 TLR3, CD283; toll-like receptor 3
K05404 TLR7; toll-like receptor 7
K05411 IRF3; interferon regulatory factor 3
K05423 CSF3, GCSF; granulocyte colony-stimulating factor
K05427 CSF2, GMCSF; granulocyte-macrophage colony-stimulating factor
K05859 PLCG2; phosphatidylinositol phospholipase C, gamma-2 [EC:3.1.4.11 ]
K06059 ADAM17, TACE, CD156b; disintegrin and metalloproteinase domain-containing protein 17 [EC:3.4.24.86 ]
K06472 FCGR2A, CD32; low affinity immunoglobulin gamma Fc receptor II-a
K06496 SELP, CD62P; selectin, platelet
K06724 NRP1, CD304; neuropilin 1
K06856 IGH; immunoglobulin heavy chain
K07209 IKBKB, IKKB; inhibitor of nuclear factor kappa-B kinase subunit beta [EC:2.7.11.10 ]
K07210 IKBKG, IKKG, NEMO; inhibitor of nuclear factor kappa-B kinase subunit gamma
K07211 IKBKE, IKKE; inhibitor of nuclear factor kappa-B kinase subunit epsilon [EC:2.7.11.10 ]
K08523 HBEGF; heparin-binding EGF-like growth factor
K10030 IL8, CXCL8; interleukin 8
K10159 TLR2, CD282; toll-like receptor 2
K10160 TLR4, CD284; toll-like receptor 4
K10170 TLR8, CD288; toll-like receptor 8
K11220 STAT1; signal transducer and activator of transcription 1
K11221 STAT2; signal transducer and activator of transcription 2
K12159 ISG15; ubiquitin cross-reactive protein
K12646 RIGI, DDX58; ATP-dependent RNA helicase DDX58 [EC:5.6.2.6 ]
K12647 IFIH1, MDA5; interferon-induced helicase C domain-containing protein 1 [EC:5.6.2.6 ]
K12648 MAVS, IPS1; mitochondrial antiviral-signaling protein
K12654 STING1, TMEM173, MITA; stimulator of interferon genes protein
K12671 CXCL10, IP10; C-X-C motif chemokine 10
K12800 NLRP3, PYPAF1; NACHT, LRR and PYD domains-containing protein 3
K12968 ADAR, ADAR1; double-stranded RNA-specific adenosine deaminase [EC:3.5.4.37 ]
K14624 CCL2, MCP1; C-C motif chemokine 2
K14754 MX; interferon-induced GTP-binding protein Mx
K16195 EIF2AK2; eukaryotic translation initiation factor 2-alpha kinase 2 [EC:2.7.11.1 ]
K21421 NOX2, GP91, CYBB; NADPH oxidase 2 [EC:1.-.-.-]
K24106 N; SARS coronavirus nucleocapsid protein
K24150 M; SARS coronavirus membrane protein
K24151 E; SARS coronavirus envelope small membrane protein
K24152 S; SARS coronavirus spike glycoprotein
K24579 3a; SARS coronavirus accessory protein 3a
K24580 6; SARS coronavirus accessory protein 6
K24581 7a; SARS coronavirus accessory protein 7a
K24582 7b; SARS coronavirus accessory protein 7b
K24583 8; SARS coronavirus accessory protein 8
K24584 10; SARS coronavirus accessory protein 10
K25011 nsp1; SARS coronavirus host translation inhibitor nsp1
K25012 nsp2; SARS coronavirus non-structural protein 2
K25013 nsp3; SARS coronavirus non-structural protein 3
K25014 nsp4; SARS coronavirus non-structural protein 4
K25015 nsp5; SARS coronavirus 3C-like proteinase
K25016 nsp6; SARS coronavirus non-structural protein 6
K25017 nsp7; SARS coronavirus non-structural protein 7
K25018 nsp8; SARS coronavirus non-structural protein 8
K25019 nsp9; SARS coronavirus non-structural protein 9
K25020 nsp10; SARS coronavirus non-structural protein 10
K25021 nsp12; Coronaviridae RNA-directed RNA polymerase
K25022 nsp13; SARS coronavirus helicase
K25023 nsp14; SARS coronavirus proofreading exoribonuclease
K25024 nsp15; SARS coronavirus uridylate-specific endoribonuclease
K25025 nsp16; SARS coronavirus 2'-O-methyltransferase
Compound
Reference
Authors
Harrison AG, Lin T, Wang P
Title
Mechanisms of SARS-CoV-2 Transmission and Pathogenesis.
Journal
Reference
Authors
Perico L, Benigni A, Casiraghi F, Ng LFP, Renia L, Remuzzi G
Title
Immunity, endothelial injury and complement-induced coagulopathy in COVID-19.
Journal
Reference
Authors
Battagello DS, Dragunas G, Klein MO, Ayub ALP, Velloso FJ, Correa RG
Title
Unpuzzling COVID-19: tissue-related signaling pathways associated with SARS-CoV-2 infection and transmission.
Journal
Reference
Authors
Felsenstein S, Herbert JA, McNamara PS, Hedrich CM
Title
COVID-19: Immunology and treatment options.
Journal
Reference
Authors
Hojyo S, Uchida M, Tanaka K, Hasebe R, Tanaka Y, Murakami M, Hirano T
Title
How COVID-19 induces cytokine storm with high mortality.
Journal
Reference
Authors
Mahmudpour M, Roozbeh J, Keshavarz M, Farrokhi S, Nabipour I
Title
COVID-19 cytokine storm: The anger of inflammation.
Journal
Reference
Authors
Farooqi F, Dhawan N, Morgan R, Dinh J, Nedd K, Yatzkan G
Title
Treatment of Severe COVID-19 with Tocilizumab Mitigates Cytokine Storm and Averts Mechanical Ventilation During Acute Respiratory Distress: A Case Report and Literature Review.
Journal
Reference
Authors
Jamilloux Y, Henry T, Belot A, Viel S, Fauter M, El Jammal T, Walzer T, Francois B, Seve P
Title
Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions.
Journal
Reference
Authors
Kiselevskiy M, Shubina I, Chikileva I, Sitdikova S, Samoylenko I, Anisimova N, Kirgizov K, Suleimanova A, Gorbunova T, Varfolomeeva S
Title
Immune Pathogenesis of COVID-19 Intoxication: Storm or Silence?
Journal
Reference
Authors
Curran CS, Rivera DR, Kopp JB
Title
COVID-19 Usurps Host Regulatory Networks.
Journal
Reference
Authors
Quan C, Li C, Ma H, Li Y, Zhang H
Title
Immunopathogenesis of Coronavirus-Induced Acute Respiratory Distress Syndrome (ARDS): Potential Infection-Associated Hemophagocytic Lymphohistiocytosis.
Journal
Reference
Authors
Ahmed-Hassan H, Sisson B, Shukla RK, Wijewantha Y, Funderburg NT, Li Z, Hayes D Jr, Demberg T, Liyanage NPM
Title
Innate Immune Responses to Highly Pathogenic Coronaviruses and Other Significant Respiratory Viral Infections.
Journal
Reference
Authors
Tay MZ, Poh CM, Renia L, MacAry PA, Ng LFP
Title
The trinity of COVID-19: immunity, inflammation and intervention.
Journal
Reference
Authors
Xia H, Cao Z, Xie X, Zhang X, Chen JY, Wang H, Menachery VD, Rajsbaum R, Shi PY
Title
Evasion of Type I Interferon by SARS-CoV-2.
Journal
Reference
Authors
Hartenian E, Nandakumar D, Lari A, Ly M, Tucker JM, Glaunsinger BA
Title
The molecular virology of coronaviruses.
Journal
Reference
Authors
Amor S, Fernandez Blanco L, Baker D
Title
Innate immunity during SARS-CoV-2: evasion strategies and activation trigger hypoxia and vascular damage.
Journal
Reference
Authors
Catanzaro M, Fagiani F, Racchi M, Corsini E, Govoni S, Lanni C
Title
Immune response in COVID-19: addressing a pharmacological challenge by targeting pathways triggered by SARS-CoV-2.
Journal
Reference
Authors
Jafarzadeh A, Chauhan P, Saha B, Jafarzadeh S, Nemati M
Title
Contribution of monocytes and macrophages to the local tissue inflammation and cytokine storm in COVID-19: Lessons from SARS and MERS, and potential therapeutic interventions.
Journal
Reference
Authors
Merad M, Martin JC
Title
Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages.
Journal
Reference
Authors
South AM, Tomlinson L, Edmonston D, Hiremath S, Sparks MA
Title
Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic.
Journal
Reference
Authors
Furuhashi M, Moniwa N, Takizawa H, Ura N, Shimamoto K
Title
Potential differential effects of renin-angiotensin system inhibitors on SARS-CoV-2 infection and lung injury in COVID-19.
Journal
Reference
Authors
Gemmati D, Bramanti B, Serino ML, Secchiero P, Zauli G, Tisato V
Title
COVID-19 and Individual Genetic Susceptibility/Receptivity: Role of ACE1/ACE2 Genes, Immunity, Inflammation and Coagulation. Might the Double X-chromosome in Females Be Protective against SARS-CoV-2 Compared to the Single X-Chromosome in Males?
Journal
Reference
Authors
Kielian M
Title
Enhancing host cell infection by SARS-CoV-2.
Journal
Reference
Authors
Risitano AM, Mastellos DC, Huber-Lang M, Yancopoulou D, Garlanda C, Ciceri F, Lambris JD
Title
Complement as a target in COVID-19?
Journal
Reference
Authors
Noris M, Benigni A, Remuzzi G
Title
The case of complement activation in COVID-19 multiorgan impact.
Journal
Reference
Authors
Polycarpou A, Howard M, Farrar CA, Greenlaw R, Fanelli G, Wallis R, Klavinskis LS, Sacks S
Title
Rationale for targeting complement in COVID-19.
Journal
Reference
Authors
Teuwen LA, Geldhof V, Pasut A, Carmeliet P
Title
COVID-19: the vasculature unleashed.
Journal
Reference
Authors
Jodele S, Kohl J
Title
Tackling COVID-19 infection through complement-targeted immunotherapy.
Journal
Reference
Authors
Chauhan AJ, Wiffen LJ, Brown TP
Title
COVID-19: A collision of complement, coagulation and inflammatory pathways.
Journal
Reference
Authors
Colling ME, Kanthi Y
Title
COVID-19-associated coagulopathy: An exploration of mechanisms.
Journal
Reference
Authors
McFadyen JD, Stevens H, Peter K
Title
The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications.
Journal
Reference
Authors
Shi M, Wang L, Fontana P, Vora S, Zhang Y, Fu TM, Lieberman J, Wu H
Title
SARS-CoV-2 Nsp1 suppresses host but not viral translation through a bipartite mechanism.
Journal
Reference
Authors
Paniri A, Akhavan-Niaki H
Title
Emerging role of IL-6 and NLRP3 inflammasome as potential therapeutic targets to combat COVID-19: Role of lncRNAs in cytokine storm modulation.
Journal
Reference
Authors
Omarjee L, Janin A, Perrot F, Laviolle B, Meilhac O, Mahe G
Title
Targeting T-cell senescence and cytokine storm with rapamycin to prevent severe progression in COVID-19.
Journal
Reference
Authors
Zhang S, Li L, Shen A, Chen Y, Qi Z
Title
Rational Use of Tocilizumab in the Treatment of Novel Coronavirus Pneumonia.
Journal
Related pathway
ko04270 Vascular smooth muscle contraction
ko04610 Complement and coagulation cascades
ko04613 Neutrophil extracellular trap formation
ko04620 Toll-like receptor signaling pathway
ko04621 NOD-like receptor signaling pathway
ko04622 RIG-I-like receptor signaling pathway
ko04623 Cytosolic DNA-sensing pathway
ko04650 Natural killer cell mediated cytotoxicity
ko04666 Fc gamma R-mediated phagocytosis
ko04670 Leukocyte transendothelial migration