Impact of cytokine storm and systemic inflammation on liver impairment patients infected by SARS-CoV-2: Prospective therapeutic challenges

COVID-19 is currently considered an inflammatory disease affecting the entire organism. In severe forms, an augmented inflammatory response leads to the fulminant “cytokine storm”, which may result in severe multisystemic end-organ damage. Apart from the acute inflammatory response, it seems that chronic inflammation also plays a major role in the clinical evolution of COVID-19 patients. Pre-existing inflammatory conditions, such as those associated with chronic coronary diseases, type 2 diabetes mellitus or obesity, may be associated with worse clinical outcomes in the context of COVID-19 disease. These comorbidities are reported as powerful predictors of poor outcomes and death following COVID-19 disease. Moreover, in the context of chronic coronary syndrome, the cytokine storm triggered by SARS-CoV-2 infection may favor vulnerabilization and rupture of a silent atheromatous plaque, with consequent acute coronary syndrome, leading to a sudden deterioration of the clinical condition of the patient. This review aims to present the current status of knowledge regarding the link between COVID-19 mortality, systemic inflammation and several major diseases associated with poor outcomes, such as cardiovascular diseases, diabetes and obesity.

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Postinfectious COVID-19 Catatonia: A Report of Two Cases

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.696347 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tyler Torrico ◽

Timothy Kiong ◽

Carlos D'Assumpcao ◽

Uyi Aisueni ◽

Fouad Jaber ◽

...

Keyword(s):

Systemic Inflammation ◽

Respiratory Symptoms ◽

Positive Response ◽

Neuropsychiatric Symptoms ◽

Cytokine Storm ◽

Common Complication ◽

Hypoxic Injury ◽

Anxiety Depression ◽

Work Up ◽

New Onset

Neuropsychiatric symptoms are a common complication of COVID-19, with symptoms documented both during acute COVID-19 infection (parainfectious) and persisting or developing after the resolution of respiratory symptoms (postinfectious). Patients have presented with a variety of symptoms such as anosmia, thrombotic events, seizures, cognitive and attention deficits, new-onset anxiety, depression, psychosis, and rarely catatonia. Etiology appears to be related to disruption of regular neurotransmission and hypoxic injury secondary to systemic inflammation and cytokine storm. Although rare, catatonia and each of its subtypes have now been reported as complications of COVID-19 and therefore should be considered known to occur in both the parainfectious and postinfectious states. Diagnosis of catatonia in the context of COVID-19 should be considered when work-up for more common medical causes of encephalopathy are negative, there is no identifiable psychiatric etiology for catatonia, and there is a positive response to benzodiazepines.

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

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.675310 ◽

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.

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Interleukin-17A (IL-17A): the silent amplifier of COVID-19

10.22541/au.161826946.65721162/v1 ◽

2021 ◽

Author(s):

Francesco Maione ◽

Gian Casillo ◽

Federica Raucci ◽

Mariarosaria Bucci

Keyword(s):

Immune Response ◽

Disease Progression ◽

Clinical Outcomes ◽

Disease Severity ◽

Systemic Inflammation ◽

Therapeutic Strategies ◽

Cytokine Storm ◽

Interleukin 17A ◽

Potential Link ◽

Per Se

One of the hallmarks of COVID-19 is the cytokine storm that provokes primarily pneumonia followed by systemic inflammation. Emerging evidence has identified a potential link between elevated levels of interleukin-17A (IL-17A) and disease severity and progression. Considering that per se IL-17A can activate several inflammatory pathways, it is plausible to hypothesize an involvement of this cytokine in COVID-19 clinical outcomes. Thus, this cytokine can represent a marker of disease progression and/or a target to develop therapeutic strategies. This hypothesis paper aims to propose this “unique” cytokine as a silent amplifier of the COVID-19 immune response and (potentially) related therapy.

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