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editorial
. 2021 Jan 6;9(3):1163–1165. doi: 10.1016/j.jaip.2020.12.033

Figure 1.

Figure 1

The paradoxical role of type 2 inflammation in regulation of asthma control and response to infection with SARS-CoV-2. Type 2 activation involves IL-5 with eosinophilia and IL-13 with raised FeNO and IgE. IL13 also acts to downregulate ACE2 and upregulate TMPRSS2 cell entry receptors for SARS-CoV-2. Increased eosinophils are accompanied by worse asthma control but protective against severe COVID-19. In asthma there may a degree of innate eosinophilic antiviral insufficiency resulting in attenuated viral clearance. ACE2, Angiotensin converting enzyme 2; FeNO, fractional exhaled nitric oxide; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TMPRSS2, transmembrane protease serine-2.