scholarly journals Prospective approach to manage COVID-19-related cytokine storm; an updated review on current concepts

2021 ◽  
Vol 6 (1) ◽  
pp. e20-e20
Author(s):  
Mohaddeseh Bahmani ◽  
Lillian Saberian
Keyword(s):  
Clinical Trials ◽  
Immune System ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
The Novel ◽  
Cytokine Storm ◽  
Human Coronavirus ◽  
Immune Imbalance ◽  
The City ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Coronavirus disease 2019 or COVID-19, caused by the novel human coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first emerged in late 2019, in the city of Wuhan, Hubei province, China. Unfortunately, despite many efforts to find cures for SARS-CoV-2 disease, still the management of severe cases remains challenging. In severe forms of COVID-19, proinflammatory cytokines are notably elevated (3) and reminiscent of the secondary hemophagocytic lymphohistiocytosis (HLH). According to many studies, immune imbalance and an uncontrolled massive release of inflammatory cytokines have a significant role in COVID-19 severity and ARDS pathophysiology. Accordingly, targeting the over-activated immune system to prevent tissue damage is now one of the most noticed possible strategies to manage severe COVID-19 cases. In the present study, we reviewed studies and clinical trials conducted in this regard.

scholarly journals Functionalized Dendrimer Platforms as a New Forefront Arsenal Targeting SARS-CoV-2: An Opportunity

Pharmaceutics ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1513
Author(s):  
Serge Mignani ◽  
Xiangyang Shi ◽  
Andrii Karpus ◽  
Giovanni Lentini ◽  
Jean-Pierre Majoral
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
The Novel ◽  
Cytokine Storm ◽  
Human Coronavirus ◽  
Important Means ◽  
Inflammatory Drugs ◽  
Approved Drugs ◽  
Pro Inflammatory Cytokines

The novel human coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused a pandemic. There are currently several marketed vaccines and many in clinical trials targeting SARS-CoV-2. Another strategy is to repurpose approved drugs to decrease the burden of the COVID-19 (official name for the coronavirus disease) pandemic. as the FDA (U.S. Food and Drug Administration) approved antiviral drugs and anti-inflammatory drugs to arrest the cytokine storm, inducing the production of pro-inflammatory cytokines. Another view to solve these unprecedented challenges is to analyze the diverse nanotechnological approaches which are able to improve the COVID-19 pandemic. In this original minireview, as promising candidates we analyze the opportunity to develop biocompatible dendrimers as drugs themselves or as nanocarriers against COVID-19 disease. From the standpoint of COVID-19, we suggest developing dendrimers as shields against COVID-19 infection based on their capacity to be incorporated in several environments outside the patients and as important means to stop transmission of SARS-CoV-2.

scholarly journals Cytokine Storm: The Primary Determinant for the Pathophysiological Evolution of COVID-19 Deterioration

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruirong Chen ◽  
Zhien Lan ◽  
Jujian Ye ◽  
Limin Pang ◽  
Yi Liu ◽  
...  
Keyword(s):  
Immune Response ◽  
Acute Respiratory Distress Syndrome ◽  
Immune System ◽  
Severe Acute Respiratory Syndrome ◽  
Distress Syndrome ◽  
The Novel ◽  
Cytokine Storm ◽  
Major Threat ◽  
Primary Determinant ◽  
Multi Organ Dysfunction Syndrome

The coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an ongoing major threat to global health and has posed significant challenges for the treatment of severely ill COVID-19 patients. Several studies have reported that cytokine storms are an important cause of disease deterioration and death in COVID-19 patients. Consequently, it is important to understand the specific pathophysiological processes underlying how cytokine storms promote the deterioration of COVID-19. Here, we outline the pathophysiological processes through which cytokine storms contribute to the deterioration of SARS-CoV-2 infection and describe the interaction between SARS-CoV-2 and the immune system, as well as the pathophysiology of immune response dysfunction that leads to acute respiratory distress syndrome (ARDS), multi-organ dysfunction syndrome (MODS), and coagulation impairment. Treatments based on inhibiting cytokine storm-induced deterioration and occurrence are also described.

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

2020 ◽  
Author(s):  
Ligong Lu ◽  
Hui Zhang ◽  
Meixiao Zhan ◽  
Jun Jiang ◽  
Hua Yin ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
Inflammatory Cytokine ◽  
Inflammatory Mediator ◽  
Therapeutic Strategies ◽  
Cytokine Storm ◽  
Critical Factors ◽  
Patient Death ◽  
Three Stages

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.

scholarly journals The LIFE CYCLE OF COVID-19 STAGES AND TREATMENT

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Ripu Daman M. Singh ◽  
Nida Malim ◽  
Aves Raza Khan ◽  
Huda Khan ◽  
Nauman Khatib ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Life Cycle ◽  
Severe Acute Respiratory Syndrome ◽  
Late Phase ◽  
Antiviral Drug ◽  
Cytokine Storm ◽  
Clinical Recovery ◽  
The World ◽  
Autoimmune Conditions ◽  
Viral Outbreak

The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)bat viruses, therefore bats could be the possible primary reservoir , which emerged in Wuhan, China and spread around the world. The intermediate source of origin and transfer to humans is not known, however, the rapid human to human transfer has been confirmed widely. There is no clinically approved antiviral drug or vaccine available to be used against COVID-19. However, few broad-spectrum antiviral drugs have been evaluated against COVID-19 in clinical trials, resulted in clinical recovery. We also discuss the approaches for  therapeutic combinations to cope with this viral outbreak. Chloroquine has been sporadically used in treating SARS-CoV-2 infection. Hydroxychloroquine shares the same mechanism of action as chloroquine, but its more tolerable safety profile makes it the preferred drug to treat malaria and autoimmune conditions. We propose that the immunomodulatory effect of hydroxychloroquine also may be useful in controlling the cytokine storm that occurs late-phase in critically ill SARS-CoV-2 infected patients.

scholarly journals Medicines for the Treatment Of COVID-19: Awaiting the Evidence

2020 ◽  
Vol 33 (7-8) ◽  
pp. 500
Author(s):  
Natalia Marto ◽  
Emília C. Monteiro
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
The Novel ◽  
Off Label Use ◽  
Promising Candidate ◽  
Off Label ◽  
Health Authorities ◽  
Investigational Drugs ◽  
The World ◽  
Repurposed Drugs

The novel severe acute respiratory syndrome coronavirus 2 is the cause of Coronavirus Disease 2019, a new illness with no effective treatment or vaccine that has reached pandemic proportions. In this document, we analyze how health authorities and agencies around the world position themselves regarding the off-label use of repurposed drugs or new investigational drugs to treat Coronavirus Disease 2019. We review the most promising candidate medicines, including available evidence, clinical recommendations and current options for access. Our concluding remarks stress the importance of administering off-label and investigational drugs in the setting of clinical trials, or at least in standardized scenarios, to generate as much scientific knowledge as achievable while engaging in the best efforts to treat patients and save lives.

scholarly journals Inflammatory Response in COVID-19 Patients Resulting from the Interaction of the Inflammasome and SARS-CoV-2

2021 ◽  
Vol 22 (15) ◽  
pp. 7914
Author(s):  
So Yeong Cheon ◽  
Bon-Nyeo Koo
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Response ◽  
Immune Complex ◽  
Inflammatory Cytokines ◽  
Immune Cells ◽  
Organ Damage ◽  
Cytokine Storm ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Pro Inflammatory Cytokines

The outbreak of the coronavirus disease 2019 (COVID-19) began at the end of 2019. COVID-19 is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and patients with COVID-19 may exhibit poor clinical outcomes. Some patients with severe COVID-19 experience cytokine release syndrome (CRS) or a cytokine storm—elevated levels of hyperactivated immune cells—and circulating pro-inflammatory cytokines, including interleukin (IL)-1β and IL-18. This severe inflammatory response can lead to organ damage/failure and even death. The inflammasome is an intracellular immune complex that is responsible for the secretion of IL-1β and IL-18 in various human diseases. Recently, there has been a growing number of studies revealing a link between the inflammasome and COVID-19. Therefore, this article summarizes the current literature regarding the inflammasome complex and COVID-19.

scholarly journals Potential neurological manifestations of COVID-19

2020 ◽  
pp. 10.1212/CPJ.0000000000000897 ◽  
Author(s):  
Anna S. Nordvig ◽  
Kathryn T. Rimmer ◽  
Joshua Z. Willey ◽  
Kiran T. Thakur ◽  
Amelia K. Boehme ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
The Novel ◽  
Altered Consciousness ◽  
Human Coronavirus ◽  
Neurological Morbidity ◽  
Neurological Patients ◽  
Neurological Effects

AbstractPurposeof review: Neurological complications are increasingly recognized in the Coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This coronavirus is related to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and other human coronavirus-related illnesses that are associated with neurological symptoms. These symptoms raise the question of a neuroinvasive potential of SARS-CoV-2.Recent findings:Potential neurological symptoms and syndromes of SARS-CoV-2 include headache, fatigue, dizziness, anosmia, ageusia, anorexia, myalgias, meningoencephalitis, hemorrhage, altered consciousness, Guillain-Barré Syndrome, syncope, seizure, and stroke. Additionally, we discuss neurological effects of other coronaviruses, special considerations for management of neurological patients, and possible long-term neurological and public health sequelae.Summary:As SARS-CoV-2 is projected to infect a large part of the world’s population, understanding the potential neurological implications of COVID-19 will help neurologists and others recognize and intervene in neurological morbidity during and after the pandemic of 2020.

scholarly journals COVID-19 Pathology on Various Organs and Regenerative Medicine and Stem Cell-Based Interventions

2021 ◽  
Vol 9 ◽  
Author(s):  
Babak Arjmand ◽  
Sepideh Alavi-Moghadam ◽  
Peyvand Parhizkar Roudsari ◽  
Mostafa Rezaei-Tavirani ◽  
Fakher Rahim ◽  
...  
Keyword(s):  
Stem Cell ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
Systemic Inflammation ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
Functional Impairments ◽  
Therapeutic Approaches ◽  
Novel Coronavirus ◽  
Pro Inflammatory Cytokines

Severe acute respiratory syndrome-coronavirus 2, a novel betacoronavirus, has caused the global outbreak of a contagious infection named coronavirus disease-2019. Severely ill subjects have shown higher levels of pro-inflammatory cytokines. Cytokine storm is the term that can be used for a systemic inflammation leading to the production of inflammatory cytokines and activation of immune cells. In coronavirus disease-2019 infection, a cytokine storm contributes to the mortality rate of the disease and can lead to multiple-organ dysfunction syndrome through auto-destructive responses of systemic inflammation. Direct effects of the severe acute respiratory syndrome associated with infection as well as hyperinflammatory reactions are in association with disease complications. Besides acute respiratory distress syndrome, functional impairments of the cardiovascular system, central nervous system, kidneys, liver, and several others can be mentioned as the possible consequences. In addition to the current therapeutic approaches for coronavirus disease-2019, which are mostly supportive, stem cell-based therapies have shown the capacity for controlling the inflammation and attenuating the cytokine storm. Therefore, after a brief review of novel coronavirus characteristics, this review aims to explain the effects of coronavirus disease-2019 cytokine storm on different organs of the human body. The roles of stem cell-based therapies on attenuating cytokine release syndrome are also stated.

scholarly journals May Medium Cut-Off Dialysis Membranes Have Impact on Outcome of COVID-19 Hemodialysis Patients?

2020 ◽  
Author(s):  
SERKAN FEYYAZ YALIN ◽  
AHMET MURT ◽  
MEVLUT TAMER DINCER ◽  
ERGUN PARMAKSIZ ◽  
SERAP YADIGAR ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
Medical Records ◽  
Kidney Diseases ◽  
Hemodialysis Patients ◽  
Cytokine Storm ◽  
Radiologic Findings ◽  
Middle Molecules ◽  
Cytokine Levels ◽  
Dialysis Membranes

Abstract Purpose: Severe acute respiratory syndrome coronavirus 2 which is a novel type of coronavirus, may lead to high levels of expression of inflammatory cytokines. Medium cut-off membranes may make greater clearances for large-middle molecules (including cytokines) than low flux membranes. In this study, we aimed to evaluate impact of type of hemodialysis membranes on outcome of COVID 19+ hemodialysis patients.Methods: Forty nine COVID 19 + hemodialysis patients were included into study. The patients were categorized into two groups regarding type of hemodialysis membranes. Clinical data, etiologies of kidney diseases, comorbidities, laboratory and radiologic findings, antiviral, anti-cytokine treatments, and hemodialysis data were taken from medical records. Results: Medium cut-off membranes were used in 15 patients and low flux membranes were used in 34 patients. There were significantly more patients with comorbidities in medium cut-off group compare to low flux group (p=0,014). CRP and ferritin which are each surragates of cytokine storm in COVID-19, were significantly higher in medium cut-off membrane group compare to low flux group (p=0,00, 0,01, respectively).Conclusion: It may be an option to use medium cut-off membranes in hemodialysis patients with COVID 19 in order to reduce cytokine levels and prevent cytokine storm.

scholarly journals Clinical Trials of Repurposed Antivirals for SARS-CoV-2

2020 ◽  
Vol 64 (9) ◽  
Author(s):  
Miguel Angel Martinez
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Controlled Trials ◽  
Open Label ◽  
Human Coronavirus ◽  
Randomized Controlled ◽  
Therapeutic Results ◽  
Repurposed Drugs ◽  
Poor Efficacy

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has prompted the repurposing of drugs on the basis of promising in vitro and therapeutic results with other human coronavirus diseases, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). These repurposed drugs have mainly included remdesivir, favipiravir, lopinavir-ritonavir, ribavirin, interferons, and hydroxychloroquine. Unfortunately, the first open-label, randomized, controlled trials are showing poor efficacy of these repurposed drugs. These results highlight the necessity of identifying and characterizing specific and potent SARS-CoV-2 antivirals.

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