A guide to immunotherapy for COVID-19

Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in cli...

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Vydáno v:Nature medicine Ročník 28; číslo 1; s. 39 - 50
Hlavní autoři: van de Veerdonk, Frank L., Giamarellos-Bourboulis, Evangelos, Pickkers, Peter, Derde, Lennie, Leavis, Helen, van Crevel, Reinout, Engel, Job J., Wiersinga, W. Joost, Vlaar, Alexander P. J., Shankar-Hari, Manu, van der Poll, Tom, Bonten, Marc, Angus, Derek C., van der Meer, Jos W. M., Netea, Mihai G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York Nature Publishing Group US 01.01.2022
Nature Publishing Group
Témata:
631/250
631/250/251
Algorithms
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Antibodies, Neutralizing - therapeutic use
Anticoagulants - therapeutic use
Azetidines - therapeutic use
Biomedical and Life Sciences
Biomedicine
Bradykinin - analogs & derivatives
Bradykinin - therapeutic use
Bradykinin B2 Receptor Antagonists - therapeutic use
Cancer Research
Clinical decision making
Clinical trials
Complement Inactivating Agents - therapeutic use
Coronaviruses
COVID-19
COVID-19 - immunology
COVID-19 - therapy
Cytokines
Decision making
Dexamethasone - therapeutic use
Drug Combinations
Factor Xa Inhibitors - therapeutic use
Glucocorticoids - therapeutic use
Heparin - therapeutic use
Heterogeneity
Humans
Hydrocortisone - therapeutic use
Imatinib Mesylate - therapeutic use
Immunization, Passive
Immunologic Factors - therapeutic use
Immunomodulation
Immunotherapy
Infectious Diseases
Interferon beta-1a - therapeutic use
Interferon beta-1b - therapeutic use
Interferon-gamma - therapeutic use
Interleukin 1 Receptor Antagonist Protein - therapeutic use
Kallikrein-Kinin System
Metabolic Diseases
Molecular Medicine
Neurosciences
Patients
Phenotypes
Piperidines - therapeutic use
Protein Kinase Inhibitors - therapeutic use
Purines - therapeutic use
Pyrazoles - therapeutic use
Pyrimidines - therapeutic use
Review Article
SARS-CoV-2
Steroid hormones
Sulfonamides - therapeutic use
ISSN:1078-8956, 1546-170X, 1546-170X
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Popis
Shrnutí:Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in clinical decision-making arise from the complexity of the disease phenotypes and patient heterogeneity, as well as the variable quality of evidence from immunotherapy studies. This Review aims to support clinical decision-making by providing an overview of the evidence generated by major clinical trials of host-directed therapy. We discuss patient stratification and propose an algorithm to guide the use of immunotherapy strategies in the clinic. This will not only help guide treatment decisions, but may also help to design future trials that investigate immunotherapy in other severe infections. This Review aims to support clinical decision-making by providing an overview of the evidence for immunotherapy strategies in patients with COVID-19.
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ISSN:1078-8956
1546-170X
1546-170X
DOI:10.1038/s41591-021-01643-9