Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies

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 concentrati...

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Vydáno v:Frontiers in immunology Ročník 11; s. 1708
Hlavní autoři: Tang, Yujun, Liu, Jiajia, Zhang, Dingyi, Xu, Zhenghao, Ji, Jinjun, Wen, Chengping
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland Frontiers Media S.A 10.07.2020
Témata:
Adrenal Cortex Hormones - therapeutic use
Animals
Antibodies, Monoclonal, Humanized - pharmacology
Antibodies, Monoclonal, Humanized - therapeutic use
antimalarial agents
Antimalarials - therapeutic use
Artesunate - therapeutic use
Betacoronavirus - immunology
Coronavirus Infections - drug therapy
Coronavirus Infections - immunology
Coronavirus Infections - virology
COVID-19
cytokine storm
Hemoperfusion - methods
Humans
Hydroxychloroquine - therapeutic use
Immunoglobulins, Intravenous - therapeutic use
Immunology
immunoregulation
Interleukin-6 - antagonists & inhibitors
Interleukin-6 - metabolism
Mice
Pandemics
Pneumonia, Viral - drug therapy
Pneumonia, Viral - immunology
Pneumonia, Viral - virology
Programmed Cell Death 1 Receptor - antagonists & inhibitors
SARS-CoV-2
tocilizumab
treatment strategies
COVID-19
immunoregulation
antimalarial agents
tocilizumab
treatment strategies
cytokine storm
ISSN:1664-3224, 1664-3224
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Shrnutí: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.
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Edited by: Mario Clerici, University of Milan, Italy
These authors have contributed equally to this work
Reviewed by: Vijayakumar Velu, Emory University, United States; Sarah Rowland-Jones, University of Oxford, United Kingdom
This article was submitted to Viral Immunology, a section of the journal Frontiers in Immunology
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2020.01708