scholarly journals A Closer Look at Dexamethasone and the SARS-CoV-2-Induced Cytokine Storm: In Silico Insights of the First Life-Saving COVID-19 Drug

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1507
Author(s):  
Paul Morgan ◽  
Shareen J. Arnold ◽  
Nai-Wan Hsiao ◽  
Chih-Wen Shu
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Inflammatory Markers ◽  
Distress Syndrome ◽  
Protein Complexes ◽  
Transcriptional Level ◽  
Cytokine Storm ◽  
High Affinity ◽  
Cytokines And Chemokines ◽  
Autoimmune Destruction ◽  
Life Saving

The term cytokine storm refers to an uncontrolled overproduction of soluble inflammatory markers known as cytokines and chemokines. Autoimmune destruction of the lungs triggered by the release of these inflammatory markers often induces acute respiratory distress syndrome (ARDS). ARDS is an emergency condition with a high mortality rate in COVID-19 patients. Dexamethasone is the first repurposed corticosteroid with life-saving efficacy in patients with severe SARS-CoV-2 infection. Dexamethasone has traditionally been known to suppress the production of inflammatory markers at the transcriptional level, but its role as a direct therapeutic to neutralize cytokines, chemokines, their receptors, and functionally critical SARS-CoV-2 proteins has not yet been explored. Herein, we demonstrated that dexamethasone binds with high affinity to interlukin-1 (IL-1), IL-6, IL-8, IL-12, IL-21, INF2, TGFβ-1, INF-γ, CXCL8, some of the receptors, IL-1R, IL-21R, IFNGR, INFAR, IL-6αR-gp130, ST2 and the SARS-CoV-2 protein NSP macro X, and 3CLpro, forming stable drug–protein complexes. Our work implied that dexamethasone has the potential to directly neutralize inflammatory markers, further supporting its life-saving potential in patients with severe manifestations of COVID-19.

scholarly journals COVID-19 infected neonate presenting with cytokine storm and sepsis

2021 ◽  
Vol 8 (7) ◽  
pp. 1296
Author(s):  
Mallesh Kariyappa ◽  
Sahana Devadas ◽  
Aparna Dutt ◽  
Varun Govindarajan
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Tract Infection ◽  
Inflammatory Markers ◽  
Distress Syndrome ◽  
Clinical Syndrome ◽  
Cytokine Storm ◽  
Upper Respiratory Tract ◽  
Intravenous Antibiotics ◽  
Upper Respiratory

COVID-19, a clinical syndrome caused by the coronavirus (SARS-CoV-2) became a pandemic following an outbreak of viral pneumonitis, first identified in Wuhan, China. The disease manifestations vary ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and even death. Although most of the neonatal cases are asymptomatic, rarely, they can present with cytokine storm mimicking with similar features of sepsis. This is a case report of SARS-CoV19 positive neonate presenting with sepsis and cytokine storm, 5-day old baby born to SARS-COVID 19 positive mother presented with fever and investigations showed elevated total counts with neutrophilic predominance, thrombocytopenia suggestive of sepsis and increased inflammatory markers suggestive of cytokine storm. Blood culture was sent and baby was started on intravenous antibiotics. In view of cytokine storm intravenous dexamethasone 0.5 mg/kg/day was given intravenously for 5 days. Neonate recovered from illness after 1 week as evidenced clinically and and by the fall in inflammatory markers before discharge. This report opens the possibility of having both sepsis and cytokine storm in a SARS-CoV19 positive neonate.

scholarly journals Cytokine storm and use of anakinra in a patient with COVID-19

2020 ◽  
Vol 13 (9) ◽  
pp. e237525
Author(s):  
Priyanka Nemchand ◽  
Hassan Tahir ◽  
Rapti Mediwake ◽  
Jeffrey Lee
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Inflammatory Markers ◽  
Distress Syndrome ◽  
Interleukin 1 ◽  
Cytokine Storm ◽  
Oxygen Requirement ◽  
Autoinflammatory Disorders ◽  
Positive Effect

We present a case of a 50-year-old man with COVID-19 infection and acute respiratory distress syndrome as a result of a cytokine storm and use of anakinra, an interleukin 1-receptor antagonist that is normally used in the treatment of autoinflammatory disorders in adult patients. We saw a reduction in oxygen requirement and improvements in inflammatory markers and ferritin. Although we cannot determine its clinical efficacy from one case study, it may have a positive effect on the proinflammatory state that is associated with cytokine storm in COVID-19 infection.

scholarly journals 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

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.

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

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.

scholarly journals Cannabidiol Modulates Cytokine Storm in Acute Respiratory Distress Syndrome Induced by Simulated Viral Infection Using Synthetic RNA

2020 ◽  
Vol 5 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Hesam Khodadadi ◽  
Évila Lopes Salles ◽  
Abbas Jarrahi ◽  
Fairouz Chibane ◽  
Vincenzo Costigliola ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Viral Infection ◽  
Distress Syndrome ◽  
Cytokine Storm

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Vitamin D and COVID-19

2020 ◽  
Vol 183 (5) ◽  
pp. R133-R147 ◽  
Author(s):  
John P Bilezikian ◽  
Daniel Bikle ◽  
Martin Hewison ◽  
Marise Lazaretti-Castro ◽  
Anna Maria Formenti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Cytokine Storm ◽  
Innate And Adaptive Immunity ◽  
Disease Propagation ◽  
Potential Risk Factors ◽  
Mechanistic Basis

The SARS-CoV-2 virus responsible for the COVID-19 pandemic has generated an explosion of interest both in the mechanisms of infection leading to dissemination and expression of this disease, and in potential risk factors that may have a mechanistic basis for disease propagation or control. Vitamin D has emerged as a factor that may be involved in these two areas. The focus of this article is to apply our current understanding of vitamin D as a facilitator of immunocompetence both with regard to innate and adaptive immunity and to consider how this may relate to COVID-19 disease. There are also intriguing potential links to vitamin D as a factor in the cytokine storm that portends some of the most serious consequences of SARS-CoV-2 infection, such as the acute respiratory distress syndrome. Moreover, cardiac and coagulopathic features of COVID-19 disease deserve attention as they may also be related to vitamin D. Finally, we review the current clinical data associating vitamin D with SARS-CoV-2 infection, a putative clinical link that at this time must still be considered hypothetical.

scholarly journals Repurposing Interleukin-6 Inhibitors to Combat COVID-19

2020 ◽  
Vol 3 (2) ◽  
pp. 52-55
Author(s):  
Shumei Kato ◽  
Razelle Kurzrock
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Severe Acute Respiratory Syndrome ◽  
Interleukin 6 ◽  
Causes Of Death ◽  
Distress Syndrome ◽  
Cytokine Storm ◽  
Novel Treatment ◽  
The Us ◽  
The World ◽  
Potential Use

ABSTRACT Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a pandemic with major implications across the world. One of the most frequent causes of death from SARS-CoV-2 is fatal pneumonia from coronavirus disease 2019 (COVID-19), which is associated with the development of acute respiratory distress syndrome (ARDS). To date (as of April 2, 2020), other than supportive measures, there are no efficient therapeutic options for COVID-19–related ARDS, although the US Food and Drug Administration recently granted emergency authorization for the use of hydroxychoroquine/chloroquine for this indication (which is usually given with azithromycin). Although the pathogenesis for ARDS is under investigation, one of the major culprits is considered to be cytokine storm, especially from interleukin 6 (IL-6) release. Herein, we review potential use of IL-6 inhibitors, several of which are approved for other disease conditions, as potential novel treatment for the management of COVID-19–related ARDS.

scholarly journals Targeting potential drivers of COVID-19: Neutrophil extracellular traps

2020 ◽  
Vol 217 (6) ◽  
Author(s):  
Betsy J. Barnes ◽  
Jose M. Adrover ◽  
Amelia Baxter-Stoltzfus ◽  
Alain Borczuk ◽  
Jonathan Cools-Lartigue ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Cytokine Production ◽  
Neutrophil Extracellular Traps ◽  
Organ Damage ◽  
Clinical Severity ◽  
Pulmonary Diseases ◽  
Cytokine Storm ◽  
Extracellular Traps ◽  
Autopsy Specimen

Coronavirus disease 2019 (COVID-19) is a novel, viral-induced respiratory disease that in ∼10–15% of patients progresses to acute respiratory distress syndrome (ARDS) triggered by a cytokine storm. In this Perspective, autopsy results and literature are presented supporting the hypothesis that a little known yet powerful function of neutrophils—the ability to form neutrophil extracellular traps (NETs)—may contribute to organ damage and mortality in COVID-19. We show lung infiltration of neutrophils in an autopsy specimen from a patient who succumbed to COVID-19. We discuss prior reports linking aberrant NET formation to pulmonary diseases, thrombosis, mucous secretions in the airways, and cytokine production. If our hypothesis is correct, targeting NETs directly and/or indirectly with existing drugs may reduce the clinical severity of COVID-19.

scholarly journals Covid-19 and leptospirosis: Cytokine storm and the use of steroids

2020 ◽  
pp. 004947552097142
Author(s):  
Abraham M Ittyachen
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
The Other ◽  
High Dose ◽  
Cytokine Storm ◽  
The World ◽  
The Common ◽  
Precipitating Factor

The majority of patients with Covid-19 have a good outcome. However, complications principally of acute respiratory distress syndrome (ARDS) and multiple-organ failure can occur rapidly. Leptospirosis, a zoonotic disease, is similar to Covid-19 in that most infections are mild or asymptomatic and only a small number develop ARDS. Cytokine storm is considered to be the main incriminating factor in both. High dose steroids have been used to ameliorate the effects in leptospirosis, and similarly, reports suggest a benefit in Covid-19. SARS CoV-2 and leptospira, one a virus and the other a bacterium, are two species separated by millions of years of evolution, but producing illnesses with similar spectra, with cytokine storm being the common precipitating factor. As data are accrued from around the world, more light may be shed on features analogous to both pathways.

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