Trained Immunity: a Tool for Reducing Susceptibility to and the Severity of SARS-CoV-2 Infection

Mihai G Netea, Evangelos J Giamarellos-Bourboulis, Jorge Domínguez-Andrés, Nigel Curtis, Reinout van Crevel, Frank L van de Veerdonk, Marc Bonten

Research output: Contribution to journalReview articlepeer-review


SARS-CoV-2 infection is mild in the majority of individuals but progresses into severe pneumonia in a small proportion of patients. The increased susceptibility to severe disease in the elderly and individuals with co-morbidities argues for an initial defect in anti-viral host defense mechanisms. Long-term boosting of innate immune responses, also termed "trained immunity," by certain live vaccines (BCG, oral polio vaccine, measles) induces heterologous protection against infections through epigenetic, transcriptional, and functional reprogramming of innate immune cells. We propose that induction of trained immunity by whole-microorganism vaccines may represent an important tool for reducing susceptibility to and severity of SARS-CoV-2.

Original languageEnglish
Pages (from-to)969-977
Number of pages9
Issue number5
Early online date4 May 2020
Publication statusPublished - 28 May 2020


  • Animals
  • BCG Vaccine/immunology
  • Betacoronavirus/physiology
  • Clinical Trials as Topic
  • Coronavirus Infections/immunology
  • Humans
  • Immunity, Innate/drug effects
  • Immunomodulation
  • Lung/immunology
  • Lymphopenia/pathology
  • Middle East Respiratory Syndrome Coronavirus/physiology
  • Pandemics
  • Pneumonia, Viral/immunology
  • SARS Virus/physiology
  • Severe Acute Respiratory Syndrome/immunology
  • Virus Replication


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