tetano
Editor, Senior Moderator
Front Immunol
. 2020 Jul 10;11:1708.
doi: 10.3389/fimmu.2020.01708. eCollection 2020.
Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies
Yujun Tang[SUP] 1 [/SUP], Jiajia Liu[SUP] 1 [/SUP], Dingyi Zhang[SUP] 1 [/SUP], Zhenghao Xu[SUP] 1 [/SUP], Jinjun Ji[SUP] 1 [/SUP], Chengping Wen[SUP] 1 [/SUP]
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the pathogen that causes coronavirus disease 2019 (COVID-19). As of 25 May 2020, the outbreak of COVID-19 has caused 347,192 deaths around the world. The current evidence showed that severely ill patients tend to have a high concentration of pro-inflammatory cytokines, such as interleukin (IL)-6, compared to those who are moderately ill. The high level of cytokines also indicates a poor prognosis in COVID-19. Besides, excessive infiltration of pro-inflammatory cells, mainly involving macrophages and T-helper 17 cells, has been found in lung tissues of patients with COVID-19 by postmortem examination. Recently, increasing studies indicate that the "cytokine storm" may contribute to the mortality of COVID-19. Here, we summarize the clinical and pathologic features of the cytokine storm in COVID-19. Our review shows that SARS-Cov-2 selectively induces a high level of IL-6 and results in the exhaustion of lymphocytes. The current evidence indicates that tocilizumab, an IL-6 inhibitor, is relatively effective and safe. Besides, corticosteroids, programmed cell death protein (PD)-1/PD-L1 checkpoint inhibition, cytokine-adsorption devices, intravenous immunoglobulin, and antimalarial agents could be potentially useful and reliable approaches to counteract cytokine storm in COVID-19 patients.
Keywords: COVID-19; antimalarial agents; cytokine storm; immunoregulation; tocilizumab; treatment strategies.
. 2020 Jul 10;11:1708.
doi: 10.3389/fimmu.2020.01708. eCollection 2020.
Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies
Yujun Tang[SUP] 1 [/SUP], Jiajia Liu[SUP] 1 [/SUP], Dingyi Zhang[SUP] 1 [/SUP], Zhenghao Xu[SUP] 1 [/SUP], Jinjun Ji[SUP] 1 [/SUP], Chengping Wen[SUP] 1 [/SUP]
Affiliations
- PMID: 32754163
- PMCID: PMC7365923
- DOI: 10.3389/fimmu.2020.01708
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the pathogen that causes coronavirus disease 2019 (COVID-19). As of 25 May 2020, the outbreak of COVID-19 has caused 347,192 deaths around the world. The current evidence showed that severely ill patients tend to have a high concentration of pro-inflammatory cytokines, such as interleukin (IL)-6, compared to those who are moderately ill. The high level of cytokines also indicates a poor prognosis in COVID-19. Besides, excessive infiltration of pro-inflammatory cells, mainly involving macrophages and T-helper 17 cells, has been found in lung tissues of patients with COVID-19 by postmortem examination. Recently, increasing studies indicate that the "cytokine storm" may contribute to the mortality of COVID-19. Here, we summarize the clinical and pathologic features of the cytokine storm in COVID-19. Our review shows that SARS-Cov-2 selectively induces a high level of IL-6 and results in the exhaustion of lymphocytes. The current evidence indicates that tocilizumab, an IL-6 inhibitor, is relatively effective and safe. Besides, corticosteroids, programmed cell death protein (PD)-1/PD-L1 checkpoint inhibition, cytokine-adsorption devices, intravenous immunoglobulin, and antimalarial agents could be potentially useful and reliable approaches to counteract cytokine storm in COVID-19 patients.
Keywords: COVID-19; antimalarial agents; cytokine storm; immunoregulation; tocilizumab; treatment strategies.