Preventing Mortality in COVID-19 Patients: Which Cytokine to Target in a Raging Storm?

Frontiers in Cell and Developmental Biology
Ligong LuYou-Wen He

Abstract

Coronavirus disease 2019 (COVID-19) from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in tremendous morbidity and mortality worldwide. A major underlying cause of COVID-19 mortality is a hyperinflammatory cytokine storm in severe/critically ill patients. Although many clinical trials are testing the efficacy of targeting inflammatory cytokines/chemokines in COVID-19 patients, the critical inflammatory mediator initiating COVID-19 patient death is undefined. Here we suggest that the immunopathological pathway leading to COVID-19 mortality can be divided into three stages with distinct clinical features that can be used to guide therapeutic strategies. Our interpretation of the recently published clinical trials from COVID-19 patients suggests that the clinical efficacy in preventing COVID-19 mortality using IL-1 blockade is subjected to notable caveats, while that for IL-6 blockade is suboptimal. We discuss critical factors in determining appropriate inflammatory cytokine/chemokine targets, timing, and combination of treatments to prevent COVID-19 mortality.

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Citations

Dec 29, 2020·Frontiers in Immunology·Ralf KircheisOliver Planz
Feb 13, 2021·Cytokine & Growth Factor Reviews·Francesca CoperchiniMario Rotondi
Mar 19, 2021·Frontiers in Medicine·Yasuaki Hirooka, Yuji Nozaki
Apr 2, 2021·Frontiers in Cellular and Infection Microbiology·Mariana Guilger-CasagrandeRenata Lima
May 3, 2021·Acta neurologica Belgica·Zahra Shabani
Jun 3, 2021·Journal of Xenobiotics·Khalid O AlfaroukStephan J Reshkin
Jul 1, 2021·JAC-antimicrobial Resistance·Shamshul AnsariUNKNOWN Global AMR Insights Ambassador Network

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Methods Mentioned

BETA
bronchoalveolar
lavage

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