Keywords
Toll-like receptors
Inflammation
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Abstract
Objective: To evaluate the relationship between TLRs and COVID-19 complications, identify the innate immune response and elucidate the hyper inflammation associated with SARS-CoV-2, focusing on pulmonary, cardiovascular and neurological complications. Methods: A systematic review was carried out with a protocol submitted to PROSPERO. Studies on the expression of TLRs in adults with COVID-19 were included, focusing on inflammatory complications. Data selection and extraction were carried out independently by two reviewers. Results: Of the 1477 articles identified, 28 studies were analyzed. TLR4 was the most mentioned, associated mainly with the lung, but also with the CNS, heart, intestine and kidney. Cytokines such as IL-6, TNF-α and IL-1β, strongly associated with TLR4, have been linked to serious complications, reflecting the activation of TLRs and exacerbated inflammation in various organs. Final considerations: The association between TLR4 and cytokines indicates the importance of the innate immune response in COVID-19 complications. Therapeutic interventions focused on these receptors can reduce the severity of inflammatory complications, being a promising field for future research.
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