J Med Sci, Volume 52, Number 3 (SI), 2020, July: 29-53 29 *corresponding author: rina_susilowati@ugm.ac.id Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Volume 52, Number 3 (SI), 2020; 29-53 http://dx.doi.org/10.19106/JMedSciSI005203202004 Submitted : 2020-04-30 Accepted : 2020-06-10 Keywords: immune response; SARS-CoV-2; COVID-19; pandemic; Indonesia; Review of immune responses correlated with COVID-19 outcomes: the fght, debacle and aftermath in the Indonesian context. Dian Eurike Septyaningtrias, Jajah Fachiroh, Dewi Kartikawati Paramita, Dewajani Purnomosari, Rina Susilowati * Department of Histology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia ABSTRACT In the current pandemic, the highly contagious nature of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) leads to an enormous burden for the global health care system and creates challenging socioeconomic problems. Respiratory mucosa, the main entrance of SARS-CoV-2 infection, are equipped with an innate immune defense system as the initial response against infection. Activation of the adaptive immune system facilitates viral clearance as well as providing immunological memory for prevention from subsequent exposure. However, despite repeated efforts at implementing appropriate interventions, severe and fatal cases are continuing to occur and reports of recurrent cases need clarifcation. Host factors may contribute to the severity of the diseases while viral immune evasion is a common phenomenon leading to severe outcomes and recurrent infection. Discussions of immunological- based tests for screening, herd immunity, along with the possible advantages or potentially futile efforts of development of vaccine and alternative immunotherapy have become a part of daily household conversations. In this review, evidence of innate and adaptive immune responses or lack of them, and immunological problems relevant for SARS-CoV-2 will be summarized. Finally, perspectives for future studies especially in the Indonesian population will be sketched. ABSTRAK Pandemi severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) yang sangat menular menyebabkan beban pada sistem pelayanan kesehatan dan masalah sosial ekonomi di seluruh dunia. Mucosa tractus respiratorius, pintu masuk utama infeksi SARS-CoV-2, dilengkapi dengan system imun bawaan sebagai respon awal infeksi. Pengaktifan sistem imun adaptif memfasilitasi pembersihan virus serta menghasilkan memori imun sebagai pencegahan untuk infeksi berikutnya. Sebagian besar orang yang terinfeksi sembuh namun kasus yang parah dan fatal serta kasus infeksi berulang juga ditemukan. Faktor inang berkontribusi terhadap keparahan penyakit. Penghindaran virus dari sistem imun adalah fenomena umum yang juga mengarah pada manifestasi klinis yang parah dan infeksi berulang. Diskusi tentang pencarian kasus positif terinfeksi SARS-CoV-2 dengan deteksi antibodi, kekebalan kawanan, kemungkinan keberhasilan atau kegagalan pengembangan vaksin dan pengembangan terapi imunologi menjadi pembicaraan sehari-hari di masyarakat. Dalam telaah ini, bukti atau kurangnya bukti respon imun bawaan dan adaptif dan masalah imunologis yang relevan untuk infeksi SARS-CoV-2 akan dirangkum. Pada bagian akhir, akan didiskusikan perspektif untuk penelitian terkait dengan pandemi SARS-CoV-2 terutama pada populasi Indonesia.