scholarly journals COVID-19: cytokine storm and anticytokine therapy

2021 ◽  
Vol 17 (2) ◽  
pp. 6-13
Author(s):  
M.V. Bondar ◽  
M.M. Pylypenko ◽  
O.A. Loskutov
Keyword(s):  
Distress Syndrome ◽  
Intensive Therapy ◽  
Evidence Base ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
Multiple Organ Dysfunction ◽  
Efficacy And Safety ◽  
Nuclear Transcription Factor ◽  
Anticytokine Therapy ◽  
Pro Inflammatory Cytokines

This review describes in detail one of the key links in the pathogenesis of COVID-19 — the overproduction of pro-inflammatory cytokines that play a key role in the formation of acute respiratory distress syndrome, disseminated intravascular coagulation, multiple organ dysfunction syndromes, and causes high mortality among patients infected with COVID-19. The article deals with the basic directions of intensive therapy for the prevention of development as well as the treatment of cytokine storm and drugs for anti-cytokine therapy. Among drugs with anti-cytokine and anti-inflammatory properties, corticosteroids have the highest evidence base for efficacy and safety. The most promising drugs that require further clinical studies are those that inhibit the activity of the main intracellular regulator of the production of proinflammatory cytokines, the nuclear transcription factor kappa B of immunocompetent cells. These include turmeric-based preparations, which are now at the final stages of the pre-registration studies.

scholarly journals COVID-19-associated secondary hemophagocytic lymphohistiocytosis (cytokine storm syndrome)

2021 ◽  
Vol 76 (1) ◽  
pp. 51-66
Author(s):  
Ekaterina I. Alekseeva ◽  
Rustem F. Tepaev ◽  
Ilia Y. Shilkrot ◽  
Tatyana M. Dvoryakovskaya ◽  
Aleksander G. Surkov ◽  
...  
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
C Reactive Protein ◽  
Routine Testing ◽  
Reactive Protein ◽  
Pathogenetic Therapy ◽  
Secondary Hemophagocytic Lymphohistiocytosis ◽  
Pro Inflammatory Cytokines

In most cases, COVID-19 has a favorable outcome. However, the risk of developing critical forms of the disease, including secondary hemophagocytic lymphohistiocytosis HLH (cytokine storm syndrome), remains high. This dictates the interest in studying pathogenetic mechanisms, features of the clinical picture, laboratory and instrumental criteria for covid-19 disease. The article analyzes the causes of acute respiratory distress syndrome and multiple organ failure as manifestations of HLH. The necessity of monitoring signs of hyperinflammation (ferritin, C-reactive protein, etc., biomarkers of inflammation) and activation of thrombosis is substantiated, in order to make timely decisions about the beginning of pathogenetic therapy. However, there are limitations for routine testing of the level of Pro-inflammatory cytokines. Information about the diagnostic criteria of HLH is summarized, and the expediency of these criteria for establishing secondary HLH, which has complicated the course of COVID-19, is emphasized.

scholarly journals Specific cytokines in the inflammatory cytokine storm of patients with COVID-19-associated acute respiratory distress syndrome and extrapulmonary multiple-organ dysfunction

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jiajia Wang ◽  
Xinjing Yang ◽  
Yongsheng Li ◽  
Jian-an Huang ◽  
Junhong Jiang ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Organ Dysfunction ◽  
Inflammatory Cytokines ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
Multiple Organ Dysfunction ◽  
Tnf Α

Abstract Background To date, specific cytokines associated with development of acute respiratory distress syndrome (ARDS) and extrapulmonary multiple organ dysfunction (MOD) in COVID-19 patients have not been systematically described. We determined the levels of inflammatory cytokines in patients with COVID-19 and their relationships with ARDS and extrapulmonary MOD. Methods The clinical and laboratory data of 94 COVID-19 patients with and without ARDS were analyzed. The levels of inflammatory cytokines (interleukin 6 [IL-6], IL-8, IL-10, and tumor necrosis factor α [TNF-α]) were measured on days 1, 3, and 5 following admission. Seventeen healthy volunteers were recruited as controls. Correlations in the levels of inflammatory cytokines with clinical and laboratory variables were analyzed, furthermore, we also explored the relationships of different cytokines with ARDS and extrapulmonary MOD. Results The ARDS group had higher serum levels of all 4 inflammatory cytokines than the controls, and these levels steadily increased after admission. The ARDS group also had higher levels of IL-6, IL-8, and IL-10 than the non-ARDS group, and the levels of these cytokines correlated significantly with coagulation parameters and disseminated intravascular coagulation (DIC). The levels of IL-6 and TNF-α correlated with the levels of creatinine and urea nitrogen, and were also higher in ARDS patients with acute kidney injury (AKI). All 4 inflammatory cytokines had negative correlations with PaO2/FiO2. IL-6, IL-8, and TNF-α had positive correlations with the APACHE-II score. Relative to survivors, non-survivors had higher levels of IL-6 and IL-10 at admission, and increasing levels over time. Conclusions The cytokine storm apparently contributed to the development of ARDS and extrapulmonary MOD in COVID-19 patients. The levels of IL-6, IL-8, and IL-10 correlated with DIC, and the levels of IL-6 and TNF-α were associated with AKI. Relative to survivors, patients who died within 28 days had increased levels of IL-6 and IL-10.

Sepsis and multiple organ dysfunction

2017 ◽  
Author(s):  
Sheila Adam ◽  
Sue Osborne ◽  
John Welch
Keyword(s):  
Organ Dysfunction ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Blood Purification ◽  
Holistic Care ◽  
Main Body ◽  
Multiple Organ Dysfunction ◽  
Common Cause ◽  
Risk Of Death ◽  
Critical Care Team

Sepsis—a dysregulated systemic inflammatory response to infection—occurs at some point in most critical illnesses, and is the most common cause of multiple organ dysfunction syndrome (MODS). Patients with MODS always present great challenges to the critical care team and are often at high risk of death. This chapter discusses the latest thinking about the infective causes and complex evolution of sepsis, with details of how each of the main body systems can be affected (e.g. in the form of acute respiratory distress syndrome) and how different organ functions can be assessed and dysfunction recognized. The priorities, principles, and practicalities of holistic care and management of patients with sepsis and MODS, including adjunct therapies and blood purification, is also described.

Clinical manifestations of canine babesiosis in Hungary (63 cases)

2006 ◽  
Vol 54 (3) ◽  
pp. 367-385 ◽  
Author(s):  
Á. Máthé ◽  
K. Vörös ◽  
L. Papp ◽  
J. Reiczigel
Keyword(s):  
Distress Syndrome ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Canine Babesiosis ◽  
Clinical Observations ◽  
Immune Mediated ◽  
Significant Difference ◽  
Organ Manifestations ◽  
The Mean

Clinical observations of Babesia canis infection in 63 dogs during a 1-year period are summarised, demonstrating the pathogenicity of the Babesia strain endemic in Hungary. Most patients had babesiosis in the spring and autumn, correlating with the seasonal activity of ticks. Male animals appeared in higher numbers, probably due to an overrepresentation of outdoor dogs. Uncomplicated babesiosis was diagnosed in 32 cases. The disease affected dogs of any age in this study. Symptoms were similar to those published from other parts of the world: lethargy, fever, splenomegaly, pallor, icterus, haemoglobinuria and presence of ticks were the most common observations. Thrombocytopenia, lymphopenia and neutropenia were frequent haemogram changes. Imidocarb appeared to be highly effective in eliminating the Babesia infection. Thirty-one animals demonstrated babesiosis with complications. Most Rottweilers (7/9) developed complicated disease. Old age was a risk factor for multiple complications. Multiple organ manifestations had poor prognosis. Hepatopathy (44%), pancreatitis (33%), acute renal failure (ARF; 31%) and disseminated intravascular coagulation (DIC; 24%) were frequent complications, while immune-mediated haemolytic anaemia (IMHA; 10%), acute respiratory distress syndrome (ARDS; 6%) and cerebral babesiosis (3%) were rarely observed. There was a significant difference between the mean age of dogs having uncomplicated disease, babesiosis with a single complication and babesiosis with multiple complications (3.4, 4.8 and 8.6 years, respectively, p < 0.001). The recovery rate (78, 68 and 25%, respectively, p = 0.005) and mortality rate (3, 21 and 67%, respectively, p < 0.001) also tended to differ significantly in these groups. Systemic inflammatory response syndrome (SIRS) and DIC are two possible pathways leading to multiple organ dysfunction syndrome (MODS) in babesiosis. DIC was found to predict MODS more sensitively in this study than SIRS: there were 6 animals developing MODS out of 11 identified with DIC, while only 5 dogs developed MODS out of 22 having SIRS.

scholarly journals COVID-19 and Cytokine Storm

2020 ◽  
Author(s):  
Mustafa Kurtuluş ◽  
İbrahim Pirim
Keyword(s):  
Immune Response ◽  
Host Response ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Past Century ◽  
Viral Agent ◽  
Disease Course ◽  
Cytokine Storm ◽  
The Past ◽  
Novel Coronavirus

Although the etiopathogenesis of infections has been largely illuminated by technical and scientific developments in the past century; many issues are still not clear today. The word “there is no disease, there is a patient” is stil valid today. Because the immune response of the host is as important as the virulence of the pathogen in infections and disease course can vary a lot according to the person. Cytokine Storm is seen exactly in a group of diseases where the host response is very prominent. For this reason, Cytokine Storm Syndrome (CSS) is mostly mentioned. CSS emerging due to different inflammatory etiologies; it is an overwhelming systemic inflammation, hemodynamic imbalance, multiple organ failure, and potentially leading to death. After being first seen in Influenza in 2003 as a viral agent, CSS was seen in SARS-Cov, MERS-CoV and SARS-CoV2, which were found to be the las thuman disease from the Corona viridea family.The novel coronavirus SARS-CoV2 causes COVID-19, a pandemic threatening millions. Uncontrolled production of pro-inflammatory mediators contributes to, acut respiratory distress syndrome (ARDS) and cytokine storm syndrome in COVID-19.

scholarly journals The Use of Dupilumab in Atopic Dermatitis During Coronavirus Disease-19 Era – A Review

2020 ◽  
Vol 8 (T1) ◽  
pp. 399-407
Author(s):  
Laura Pauline Kosasih
Keyword(s):  
Atopic Dermatitis ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
T Helper ◽  
Immunomodulatory Treatment ◽  
Global Pandemic ◽  
Common Causes ◽  
Th 1 ◽  
Vast Range

The global pandemic of coronavirus (CoV) d0isease 2019 (COVID-19), caused by severe acute respiratory syndrome CoV (SARS-CoV 2), has been a challenging event for every individual. It is known that COVID-19 may exhibit a vast range of symptoms ranging from mild to severe. Acute respiratory distress syndrome (ARDS) and multiple organ failure are the most common causes of death in COVID-19 cases [3]. Accumulating evidence shows that T-helper type (Th-1) inflammation cascade plays a major role in COVID-19 pathogenesis. It is proposed that aberrant immune reaction, or known as cytokine storm, is one of the main causals of ARDS in COVID-19 case, while dupilumab, the first Food and Drug Administration-approved immunomodulatory treatment for atopic dermatitis, is known for its effectiveness in suppressing the Th-2 inflammation pathway. It is postulated that both types of inflammation can cross-regulate each other. Therefore, some may believe that the regression of Th-2 cascade may upregulate the Th-1 cascade, leading to an exaggerated cytokine storm. This hypothesis leads to the uncertainty of the safety of continuing this modality during the pandemic.

scholarly journals The Molecular Mechanism of Multiple Organ Dysfunction and Targeted Intervention of COVID-19 Based on Time-Order Transcriptomic Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Miao Zou ◽  
Xiaoyun Su ◽  
Luoying Wang ◽  
Xingcheng Yi ◽  
Yue Qiu ◽  
...  
Keyword(s):  
Gene Expression ◽  
Stress Response ◽  
Molecular Mechanism ◽  
Organ Dysfunction ◽  
Multiple Organ ◽  
Biological Processes ◽  
Cytokine Storm ◽  
Multiple Organ Dysfunction ◽  
Hub Genes ◽  
Immune Genes

Coronavirus disease 2019 (COVID-19) pandemic is caused by the novel coronavirus that has spread rapidly around the world, leading to high mortality because of multiple organ dysfunction; however, its underlying molecular mechanism is unknown. To determine the molecular mechanism of multiple organ dysfunction, a bioinformatics analysis method based on a time-order gene co-expression network (TO-GCN) was performed. First, gene expression profiles were downloaded from the gene expression omnibus database (GSE161200), and a TO-GCN was constructed using the breadth-first search (BFS) algorithm to infer the pattern of changes in the different organs over time. Second, Gene Ontology enrichment analysis was used to analyze the main biological processes related to COVID-19. The initial gene modules for the immune response of different organs were defined as the research object. The STRING database was used to construct a protein–protein interaction network of immune genes in different organs. The PageRank algorithm was used to identify five hub genes in each organ. Finally, the Comparative Toxicogenomics Database played an important role in exploring the potential compounds that target the hub genes. The results showed that there were two types of biological processes: the body’s stress response and cell-mediated immune response involving the lung, trachea, and olfactory bulb (olf) after being infected by COVID-19. However, a unique biological process related to the stress response is the regulation of neuronal signals in the brain. The stress response was heterogeneous among different organs. In the lung, the regulation of DNA morphology, angiogenesis, and mitochondrial-related energy metabolism are specific biological processes related to the stress response. In particular, an effect on tracheal stress response was made by the regulation of protein metabolism and rRNA metabolism-related biological processes, as biological processes. In the olf, the distinctive stress responses consist of neural signal transmission and brain behavior. In addition, myeloid leukocyte activation and myeloid leukocyte-mediated immunity in response to COVID-19 can lead to a cytokine storm. Immune genes such as SRC, RHOA, CD40LG, CSF1, TNFRSF1A, FCER1G, ICAM1, LAT, LCN2, PLAU, CXCL10, ICAM1, CD40, IRF7, and B2M were predicted to be the hub genes in the cytokine storm. Furthermore, we inferred that resveratrol, acetaminophen, dexamethasone, estradiol, statins, curcumin, and other compounds are potential target drugs in the treatment of COVID-19.

scholarly journals Adverse Events in Coronavirus Disease Patients Management: A Pictorial Essay

2020 ◽  
Vol 10 ◽  
pp. 42
Author(s):  
Salvatore Alessio Angileri ◽  
Mario Petrillo ◽  
Letizia Di Meglio ◽  
Antonio Arrichiello ◽  
Giovanni Maria Rodà ◽  
...  
Keyword(s):  
Adverse Events ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Unexpected Events ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Appropriate Treatment ◽  
Non Invasive Ventilation ◽  
Pictorial Essay

Clinical manifestation of coronavirus disease (COVID-19) varies from asymptomatic to severe clinical forms that can result in acute respiratory distress syndrome or in multiple organ dysfunction syndromes. There are no guidelines, based on randomized controlled trials, for the treatment of COVID-19 patients. The treatment is based on antiviral drugs, invasive and non-invasive ventilation supports, and anticoagulant therapy. This is a pictorial essay covering the multiple adverse events encountered during the treatment of COVID-19 patients in an area with a high pandemic incidence. Adverse events are defined as unexpected events following treatment for the infection. The cases described would be useful in aiding early diagnosis, limiting and improving the management of serious complications for patients, and allowing rapid and appropriate treatment.

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