Fig. 1.

Hypothesis of virus-immune pathology of COVID-19. Sequence of events. 1. SARS-CoV-2 infects nasal epithelial cells to produce virus titres. 2. The virus spreads locoregional to infect the lungs. 3. When antivirus antibodies are present, antibody-dependent infected myeloid leukocytes could transport the virus through the lymph and blood circulation, resulting in a disseminated infection. 4. Disseminated virus-antibody complexes results in amplification of activation cycles of the complement system, innate immune cells and cytokines resulting in systemic immune pathogenesis. Because of high virus titres in the lungs, this will also result in sever acute respiratory syndrome. 5. The alternative route would be effective clearance of the virus by cytotoxic T lymphocytes (and/or antibodies devoid of the capability to induce antibody-dependent infection).