Journal Article Review Epublish 18 citations
PubMed: 33790587 DOI: 10.2147/IDR.S300162
BCG Vaccine-Induced Trained Immunity and COVID-19: Protective or Bystander?
Infect Drug Resist 14:1169-1184
Authors: Gopala Koneru, Gaber El-Saber Batiha, Abdelazeem M Algammal, Mahmoud Mabrok, Sara Magdy, Shrouk Sayed, Mai E AbuElmagd, Reham Elnemr, Mahmoud M Saad, Noura H Abd Ellah, Amal Hosni, Khalid Muhammad, Helal F Hetta
Affiliations
- Department of Medicine, Division of Gastroenterology and Hepatology, Rutger New Jersey Medical School, Rutgers University, New Brunswick, NJ, 07103, USA.
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicines, Damanhour University, Damanhur, 22511, Egypt.
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt.
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt.
- Fish Infectious Diseases Research Unit (FID RU), Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand.
- Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.
- Department of Pharmaceutics, Faculty of Pharmacy, Assiut University, Assiut, 71526, Egypt.
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates.
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.
Abstract
In late 2019, a new virulent coronavirus (CoV) emerged in Wuhan, China and was named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This virus spread rapidly, causing the coronavirus disease-2019 (COVID-19) pandemic. Bacillus Calmette-Guérin (BCG) is a live attenuated tuberculosis (TB) vaccine, associated with induction of non-specific cross-protection against unrelated infections. This protection is a memory-like response in innate immune cells (trained immunity), which is caused by epigenetic reprogramming via histone modification in the regulatory elements of specific genes in monocytes. COVID-19 related epidemiological studies showed an inverse relationship between national BCG vaccination policies and COVID-19 incidence and death, suggesting that BCG may induce trained immunity that could confer some protection against SARS-CoV-2. As this pandemic has put most of Earth's population under quarantine, repurposing of the old, well-characterized BCG may ensure some protection against COVID-19. This review focuses on BCG-related cross-protection and acquisition of trained immunity, as well as the correlation between BCG vaccination and COVID-19 incidence and mortality.
MeSH
Coronavirus, Bcg Vaccine, Sars-Cov-2, Vaccines, Incidence, Vaccination, Covid-19, Tuberculosis, Viruses, Immunity, Pandemics
Cited by
- Identification of sensitive indicators in immune response for leprosy affected patients: An observational clinical study of safety and immunogenicity of influenza vaccine. Medicine (Baltimore), 2021
- An Update on Anti-COVID-19 Vaccines and the Challenges to Protect Against New SARS-CoV-2 Variants. Pathogens, 2025
- Effectiveness of booster BCG vaccination in preventing Covid-19 infection. Hum Vaccin Immunother, 2022
- Current Understanding of Bacillus Calmette-Guérin-Mediated Trained Immunity and Its Perspectives for Controlling Intracellular Infections. Pathogens, 2023
- Host genetic diversity and genetic variations of SARS-CoV-2 in COVID-19 pathogenesis and the effectiveness of vaccination. Int Immunopharmacol, 2022
- COVID-19 among staff and their family members of a healthcare research institution in Bangladesh between March 2020 and April 2021: a test-negative case-control study. BMJ Open, 2022
- Targeting of neuroinflammation by glibenclamide in Covid-19: old weapon from arsenal. Inflammopharmacology, 2023
- BCG immunization mitigates SARS-CoV-2 replication in macaques via monocyte efferocytosis and neutrophil recruitment in lungs. JCI Insight, 2025
- Immune responses in COVID-19 and tuberculosis coinfection: A scoping review. Front Immunol, 2022
- Roles of existing drug and drug targets for COVID-19 management. Metabol Open, 2021
- Prevalence and Predictors of Persistent Symptoms After Clearance of SARS-CoV-2 Infection: A Multicenter Study from Egypt. Infect Drug Resist, 2022