2021-11-24

Institute of Gerontology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Hefei National Laboratory for Physical Sciences at Microscale, The Chinese Academy of Sciences (CAS) Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Institute of Immunology, University of Science and Technology of China, Hefei, China.; Hefei National Laboratory for Physical Sciences at Microscale, The Chinese Academy of Sciences (CAS) Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Institute of Immunology, University of Science and Technology of China, Hefei, China.; Institute of Gerontology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Hefei National Laboratory for Physical Sciences at Microscale, The Chinese Academy of Sciences (CAS) Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Institute of Immunology, University of Science and Technology of China, Hefei, China.

At present, the global COVID-19 epidemic is still in a state of anxiety, and increasing the cure rate of critically ill patients is an important means to defeat the virus. From an immune perspective, ARDS driven by an inflammatory storm is still the direct cause of death in severe COVID-19 patients. Although some experience has been gained in the treatment of COVID-19, and intensive COVID-19 vaccination has been carried out recently, it is still effective to save lives to develop more effective programs to alleviate the inflammatory storm and ARDS in patients with SARS-CoV-2 or emerging variants of SARS-CoV-2. In reorganizing the ARDS-related inflammatory storm formation program in COVID-19 patients, we highlighted the importance of the vicious circle of inflammatory cytokines and inflammatory cell death, which is aggravated by blood circulation to form multi-system inflammation. Summarizes the interlocking and crisscrossing of inflammatory response and inflammatory cell death

2021-04-05

Department of Infectious Diseases, Beijing You an Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing, 100069, People's Republic of China.; Department of Infectious Diseases, Beijing You an Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing, 100069, People's Republic of China.; Department of Infectious Diseases, Beijing You an Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing, 100069, People's Republic of China.; Department of Infectious Diseases, Beijing You an Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing, 100069, People's Republic of China.; Department of Respiratory and Infectious Diseases, Beijing You an Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing, 100069, People's Republic of China.

Severe acute respiratory syndrome coronavirus clade 2 (SARS-CoV-2) is an emerging pathogen, which is similar to previous SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV) occurrences. However, we only get few understandings about the pathogenesis of SARS-CoV-2, which need to further be studied. The discovery of an agent that has a treatment efficacy against SARS-CoV-2 is very urgent. In this review, we briefly discuss the virology of this pathogen and focus on the available understanding of the pathogenesis and treatments of this pathogen including the uses of nucleoside analogues, protease inhibitors, interferons, and other small-molecule drugs, on the basis previous comprehensions of SARS and MERS. These reviewed concepts may be beneficial in providing new insights and potential treatments for COVID-19.CI - © 2021 Yang et al.

2021-02-14

State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, Nanjing, 211166, China.; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.; State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, Nanjing, 211166, China.; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.; State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, Nanjing, 211166, China.; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.; State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, Nanjing, 211166, China.; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.; Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China. sepnine@njmu.edu.cn.; State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, Nanjing, 211166, China. yankaixia@njmu.edu.cn.; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China. yankaixia@njmu.edu.cn.

BACKGROUND: Due to the rapid spread of coronavirus disease 2019 (COVID-19) worldwide, it is necessary to ascertain essential immune inflammatory parameters that describe the severity of the disease and provide guidance for treatment. We performed network meta-analyses to determine differences in blood cells, lymphocyte subsets, and cytokines in COVID-19 patients with different clinical stages. METHODS: Databases were systematically searched to May 2, 2020, and updated on June 1, 2020. Network meta-analyses were conducted via Stata 15.0, and the mean difference (MD) and its 95% CI were used as the effect values of the pooled analysis. RESULTS: Seventy-one studies were included involving 8647 COVID-19 patients, White blood cell (WBC), neutrophil (NEUT), IL-6, and IL-10 counts increased significantly with worsening of the COVID-19, while lymphocyte (LYM) counts decreased. The levels of platelet (PLT), CD3(+), CD4(+), CD8(+), and CD19(+) cells in severe and critical patients were

2021-10-31

Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England. sarah.daniels@manchester.ac.uk.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England. sarah.daniels@manchester.ac.uk.; Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Department of Mathematics, The University of Manchester, Manchester, England.; Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Division of Evolution, Infection and Genomics, School of Biological Sciences, The University of Manchester, Manchester, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Department of Mathematics, The University of Manchester, Manchester, England.; Public Health, Advice, Guidance and Expertise, London, England.; Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; United Kingdom Health Security Agency National COVID-19 Response Centre, London, England.; Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.; Department of Mathematics, The University of Manchester, Manchester, England.; Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.

BACKGROUND: Workplace transmission is a significant contributor to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. Previous studies have found that infectious illness presenteeism could contribute to outbreaks in occupational settings and identified multiple occupational and organisational risk factors. Amid the COVID-19 pandemic, it is imperative to investigate presenteeism particularly in relation to respiratory infectious disease (RID). Hence, this rapid review aims to determine the prevalence of RID-related presenteeism, including COVID-19, and examines the reported reasons and associated risk factors. METHODS: The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in English and Chinese. Database searches included MEDLINE, EMBASE, Web of Science, China Knowledge Resource Integrated Database (CNKI) and preprint databases MedRxiv and BioRxiv. RESULTS: The search

2021-02-10

Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, The First People's Hospital of Jiangxia District, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Clinical Laboratory, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.; Department of Urology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

Hemodialysis patients are susceptible to coronavirus disease 2019 (COVID-19). The aim of this study was to describe the epidemiological, clinical characteristics, and mortality-related risk factors for those who undergoing hemodialysis with COVID-19. We conducted a retrospective study. A total of 49 hemodialysis patients with COVID-19 (Group 1) and 74 uninfected patients (Group 2) were included. For patients in Group 1, we found the median age was 62 years (36-89 years), 59.3% were male, and the median dialysis vintage was 26 months. Twenty-eight patients (57%) had three or more comorbidities and two patients (4%) died. The most common symptoms were fever (32.7%) and dry cough (46.9%), while nine patients (18.4%) were asymptomatic. Blood routine tests indicated lymphocytopenia, the proportion of lymphocyte subsets was generally reduced, and chest CT scans showed ground-glass opacity (45.8%) and patchy shadowing (35.4%). However, these findings were not specific to hemodialysis

2020-03-12

Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China

2020-03-12

Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,; University of Science and Technology of China, Hefei, Anhui, 230001, China Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic; Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui 230001, China

2021-06-30

Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, China.; Drug Clinical Trail Institution, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.; Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China.; Department of Respiratory Medicine, the Second People's Hospital of Fuyang, Fuyang, 236000, China.; Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Hunan Provincial Clinical Research Center for Respiratory Diseases, Changsha, 410000, China.; Intensive Care Unit, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Intensive Care Unit, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Lu'an People's Hospital Affiliated to Anhui Medical University, Lu'an, 237005, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Bengbu Medical College, Clinical Research Center for Respiratory Disease (tumor) in Anhui Province, Bengbu, 233004, China.; Department of Respiratory Medicine, Anqing Hospital Affiliated to Anhui Medical University, Anqing, 246000, China.; The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.; Department of Rheumatology and Immunology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Oncology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Endocrinology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Endocrinology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Hematology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Rheumatology and Immunology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, China.; Intensive Care Unit, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China. hfmxd@sina.com.; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, China. ustcwhm@ustc.edu.cn.; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, 230001, China. xxlahh8@ustc.edu.cn.

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day

2021-04-08

Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China; College of Life Science, Nankai University, Tianjin 300071, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; CAS Key Laboratory of Special Pathogens and Biosafety, Centre for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China; University of Chinese Academy of Sciences, Beijing, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Department of Public Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.; Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; CAS Key Laboratory of Special Pathogens and Biosafety, Centre for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China; University of Chinese Academy of Sciences, Beijing, China.; CAS Key Laboratory of Special Pathogens and Biosafety, Centre for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China; University of Chinese Academy of Sciences, Beijing, China. Electronic address: hpwei@wh.iov.cn.; Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: zysun@tjh.tjmu.edu.cn.; Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: xlfan@hust.edu.cn.; Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China. Electronic address: taosc@sjtu.edu.cn.

To fully decipher the immunogenicity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike protein, it is essential to assess which part is highly immunogenic in a systematic way. We generate a linear epitope landscape of the Spike protein by analyzing the serum immunoglobulin G (IgG) response of 1,051 coronavirus disease 2019 (COVID-19) patients with a peptide microarray. We reveal two regions rich in linear epitopes, i.e., C-terminal domain (CTD) and a region close to the S2' cleavage site and fusion peptide. Unexpectedly, we find that the receptor binding domain (RBD) lacks linear epitope. We reveal that the number of responsive peptides is highly variable among patients and correlates with disease severity. Some peptides are moderately associated with severity and clinical outcome. By immunizing mice, we obtain linear-epitope-specific antibodies; however, no significant neutralizing activity against the authentic virus is observed for these antibodies. This