Cytokine storm intervention in the early stages of COVID-19 pneumonia

• Published in: Cytokine & growth factor reviews Vol. 53; pp. 38 - 42
• Main Authors: Sun, Xinjuan, Wang, Tianyuan, Cai, Dayong, Hu, Zhiwei, Chen, Jin’an, Liao, Hui, Zhi, Liming, Wei, Hongxia, Zhang, Zhihong, Qiu, Yuying, Wang, Jing, Wang, Aiping
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2020; The Authors. Published by Elsevier Ltd
• Subjects: Adrenal Cortex Hormones - therapeutic use; Advanced Basic Science; Antibodies, Monoclonal - therapeutic use; Betacoronavirus - immunology; Continuous Renal Replacement Therapy - methods; Coronavirus Infections - drug therapy; Coronavirus Infections - immunology; Coronavirus Infections - pathology; COVID-19; Cytokine Release Syndrome - drug therapy; Cytokine Release Syndrome - pathology; Cytokine storm; Cytokines - biosynthesis; Cytokines - blood; Female; Humans; Inflammation; Interferon-alpha - therapeutic use; Lung damage; Male; Multiple Organ Failure - immunology; Multiple Organ Failure - mortality; Multiple Organ Failure - pathology; Pandemics; Pneumonia, Viral - drug therapy; Pneumonia, Viral - immunology; Pneumonia, Viral - pathology; Polyethylene Glycols - therapeutic use; Recombinant Proteins - therapeutic use; Retrospective Studies; SARS-CoV-2; SARS-CoV2; COVID-19; SARS-CoV2; Lung damage; Inflammation; Cytokine storm
• ISSN: 1359-6101; 1879-0305
• DOI: 10.1016/j.cytogfr.2020.04.002

•COVID-19 infection can lead to the development of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome MODS within a few days of disease onset.•A powerful cytokine storm accompanies COVID-19 pneumonia.•The capacity to accurately predict and intervene in the cytokine storm during COVID-19 pneumonia, as well as the ability to design effective specific strategies to block excessive inflammation, is critical for patient survival. Clinical intervention in patients with corona virus disease 2019 (COVID-19) has demonstrated a strong upregulation of cytokine production in patients who are critically ill with SARS-CoV2-induced pneumonia. In a retrospective study of 41 patients with COVID-19, most patients with SARS-CoV-2 infection developed mild symptoms, whereas some patients later developed aggravated disease symptoms, and eventually passed away because of multiple organ dysfunction syndrome (MODS), as a consequence of a severe cytokine storm. Guidelines for the diagnosis and treatment of SARS-CoV-2 infected pneumonia were first published January 30th, 2020; these guidelines recommended for the first time that cytokine monitoring should be applied in severely ill patients to reduce pneumonia related mortality. The cytokine storm observed in COVID-19 illness is also an important component of mortality in other viral diseases, including SARS, MERS and influenza. In view of the severe morbidity and mortality of COVID-19 pneumonia, we review the current understanding of treatment of human coronavirus infections from the perspective of a dysregulated cytokine and immune response.