Graphical Abstract

- SARS-CoV-2 infection produces reactive oxygen species (ROS).
- ROS induce hypoxia-inducible factor-1$$\alpha$$ (HIF-1$$\alpha$$).
- HIF-1$$\alpha$$ induces the transcription of proinflammatory cytokines.
- This leads to increased levels of PD-1, IL-1, IL-6, and TNF-$$\alpha$$.
- It decreases anti-inflammatory cytokines, specifically decreasing IFN-$$\gamma$$.
- This pathway ultimately increases epithelial cell death and decreases T-cell proliferation.

Northwestern University

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During SARS-CoV-2 infection, elevated glucose levels and sustained aerobic glycolysis in monocytes directly promote viral replication, cytokine production, T cell dysfunction, and lung epithelial cell death.

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