Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in Covid-19 patients

Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS), which requires intensive care unit admission. These conditions have rapidly overwhelmed healthcare systems, with detrimental effects on the quality of care and increased mortality. Social isolation strategies have been implemented worldwide with the aim of reducing hospital pressure. Among therapeutic strategies, the use of immunomodulating drugs, to improve prognosis, seems promising. Particularly, since pneumonia and ARDS are associated with a cytokine storm, drugs belonging to therapeutic classes as anti-IL-6, anti-TNF and JAK inhibitors, are currently studied. In this paper, we discuss the potential advantages of the most promising pharmacological approaches.

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Acute respiratory distress syndrome caused by carbon monoxide poisoning and inhalation injury recovered after extracorporeal membrane oxygenation along with direct hemoperfusion with polymyxin B-immobilized fiber column: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-03023-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Ji Hoon Jang ◽

Hang Jea Jang ◽

Hyun-Kuk Kim ◽

Jin Han Park ◽

Hyo-Jung Kim ◽

...

Keyword(s):

Carbon Monoxide ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Carbon Monoxide Poisoning ◽

Polymyxin B ◽

Inhalation Injury ◽

Cytokine Storm ◽

Direct Hemoperfusion

Abstract Background Inhalation injury from smoke or chemical products and carbon monoxide poisoning are major causes of death in burn patients from fire accidents. Respiratory tract injuries from inhalation injury and carbon monoxide poisoning can lead to acute respiratory distress syndrome and cytokine storm syndrome. In the case of acute respiratory failure needing mechanical ventilation accompanied by cytokine storm, mortality is high and immediate adequate treatment at the emergency department is very important. Case presentation This report describes a case of acute respiratory distress syndrome and cytokine storm followed by carbon monoxide poisoning in a 34-year-old Korean male patient who was in a house fire, and was successfully treated by extracorporeal membrane oxygenation and direct hemoperfusion with polymyxin B-immobilized fiber column at emergency department. Conclusions To prevent mortality in acute respiratory distress syndrome with cytokine storm from inhalation injury and to promote a better prognosis, we suggest that early implication of extracorporeal membranous oxygenation along with direct hemoperfusion with polymyxin B-immobilized fiber column even at the emergency department should be considered.

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Effectiveness of Glucocorticoids on acute respiratory distress syndrome: An umbrella review

10.21203/rs.2.22025/v1 ◽

2020 ◽

Author(s):

Semagn Mekonnen ◽

Haile Mariam Mulugeta Kassim ◽

Bivash Basu ◽

Solomon Nega

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Systemic Review ◽

Cochrane Library ◽

Umbrella Review ◽

Quality Of Evidence ◽

Secondary Outcomes

Abstract Background Management of Acute Respiratory Distress Syndrome is a very challenging critical illness in ICU with high morbidity and mortality worldwide.The review was intended to provide evidence on the effectiveness of Glucocorticoid treatment for acute respiratory distress syndrome Method A comprehensive search strategy was conducted on PubMed/Medline, Cochrane Library, Science direct, LILACS, and African Online Journal. Data extraction was carried out with two independent authors with customized checklist. The quality of each systemic review was assessed by two independent authors using AMSTAR tool and the overall quality of evidence was generated with online GRADEpro GDT software for primary and secondary outcomes. Result The umbrella review included nine systemic reviews and meta-analysis and one narrative review with eight thousand four hundred ninety one participants. The methodological quality of the included studies was moderate to high quality. The overall quality of evidence and recommendation varied form high to very low. Conclusion There is high to moderate quality evidence on the initiation of early low dose prolonged glucocorticoid for reduction of mortality for ARDS. However, randomized controlled trials with large sample sizes to address ventilator-free days, the incidence of infection and other glucocorticoid associated adverse events is required as the quality of evidence with these secondary outcomes were low to very low

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Quality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers

Annals of Intensive Care ◽

10.1186/s13613-018-0357-y ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 7

Author(s):

Sebastian Blecha ◽

◽

Frank Dodoo-Schittko ◽

Susanne Brandstetter ◽

Magdalena Brandl ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome

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Cytokine storm syndrome in SARS-CoV-2: a review

Zeitschrift für Naturforschung C ◽

10.1515/znc-2021-0062 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Braira Wahid ◽

Noshaba Rani ◽

Muhammad Idrees

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Failure ◽

Severe Acute Respiratory Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Cytokine Storm ◽

Global Level ◽

Management Option ◽

Human Contact

Abstract After wreaking havoc on a global level with a total of 5,488,825 confirmed cases and 349,095 deaths as of May 2020, severe acute respiratory syndrome coronavirus 2 is truly living up to the expectations of a 21st-century pandemic. Since the major cause of mortality is a respiratory failure from acute respiratory distress syndrome, the only present-day management option is supportive as the transmission relies solely on human-to-human contact. Patients suffering from coronavirus disease 2019 (COVID-19) should be tested for hyper inflammation to screen those for whom immunosuppression can increases chances of survival. As more and more clinical data surfaces, it suggests patients with mild or severe cytokine storms are at greater risk of failing fatally and hence these cytokine storms should be targets for treatment in salvaging COVID-19 patients.

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