key: cord-303183-oya0pdhw authors: Bersanelli, Melissa title: COVID-19 and the newly rediscovered multidisciplinarity date: 2020-09-22 journal: Immunotherapy DOI: 10.2217/imt-2020-0205 sha: doc_id: 303183 cord_uid: oya0pdhw nan Unfortunately, SARS-CoV-2 infections often do not allow thoughtful reflections on the main components of the worsening condition of the patient, and the emergency frequently leads to messy therapeutic solutions. In the end, the same patient could have been treated with both immunesuppressants or immune-enhancers, with the aim of timely intercept of the upcoming phase of the disease. If the cruciality of the immune response in COVID-19 pathogenesis is out of the question, it is still unclear if the morbidity could be more due to an initial immune-suppressive vulnerability or, on the contrary, to a late and aberrant immune hyperactivation. The reports published in the present issue, aside from contributing to a valuable brainstorming on the underlying biological mechanisms to exploit for COVID-19 recovery, represent the testimony of the complicated rationale behind the current therapeutic approaches to the disease. If the use of tocilizumab still emerges as one of the most promising solutions, supported by scarce prospective evidence but pushed by the unmet need of an effective treatment [1, 6] , the attempt to outflank the immune system suppression has led to the proposal of an immuneprotection, exploiting physiological checkpoints to restore the immunocompetence [3] . It is the same rationale behind the immunotherapy of cancers, recently revolutionizing the therapeutic approach to solid tumors from an immunosuppressive perspective (e.g., chemotherapy) to an immunerestoring attempt [9] . The switch is difficult to accept, but in the case of oncology the clinical evidence strongly advocates the newest approach, likely the most physiological, relying more on the normalization than on the enhancement of the immunological status [10] . Indeed, the immune checkpoint blockade limits its effects in removing a block, allowing normal operation of the immune system to resume, more than enhancing the immune activation, that could even be harmful in the context of severe COVID-19. Aside from the treatment of the SARS-CoV-2 infection, primary and secondary prevention is an incredibly important concern, especially in frail populations such as those affected by cancer, hematologic malignancies, obesity, pulmonary chronic obstructive disease, cardiovascular diseases or metabolic disorders [2] [3] [4] [5] 8 ]. The first tool to be exploited for prevention is knowledge: an accurate epidemiological framework of the disease in frail populations is unfortunately still missing, given the lack of the true denominator on which COVID-cases were reported. In the current scenario, the value of reliable predictions could be even more important in the lack of prophylactic solutions, especially in light of the fact that the only effective tool applied until today was social distancing. Reliable predictions of future outbreaks, of their setting and extension, would be the only tool to prevent the evolution of events in which the world has stumbled in the last few months. In the meantime, the heartfelt research of therapeutic solutions remains a mission of physicians and researchers of all branches, sometimes contributing to creating new professional figures between immunology, infectious diseases and other specialties. Because union is strength (Figure 1 ). The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript. 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