In less than 1 year, several effective vaccines targeting the SARS-CoV-2 spike protein from multiple platforms (lipid nanoparticle-encapsulated mRNA, inactivated virion or viral-vectored vaccine platforms 6) gained emergency use authorization (EUA) or approval and were deployed to billions of people worldwide. The extensive morbidity and mortality associated with the COVID-19 pandemic made the development of SARS-CoV-2 vaccines a global health priority. The risk of COVID-19 disease severity depends on comorbidities (for example, diabetes, hypertension and obesity), age, ethnicity, genetic factors, vaccination status and other conditions 5, making understanding the underlying disease mechanisms important for risk stratification and clinical triage. However, some patients experience more severe disease and develop systemic inflammation, tissue damage, acute respiratory distress syndrome, thromboembolic complications, cardiac injury and/or cytokine storm, which can be fatal 1, 4 (Fig. Most infections remain mild, and up to 20–40% of patients are asymptomatic. SARS-CoV-2 causes upper and lower respiratory tract infections that are often associated with fever, cough and loss of smell and taste. 1, 2), SARS-CoV-2 rapidly spread throughout the world, leading to an ongoing public health crisis, and, as of 2 December 2021, there have been over 263 million infections and 5.2 million deaths 3. Initially identified in Wuhan, China in December 2019 (refs. In 2019, SARS-CoV-2 emerged as a new pathogen that resulted in the COVID-19 pandemic.
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