Biosensors for Managing the COVID-19 Cytokine Storm: Challenges Ahead

Abstract

The global COVID-19 pandemic has oversaturated many intensive care units to the point of collapse, leading to enormous spikes in death counts. Before critical care becomes a necessity, identifying patients who are likely to become critically ill and providing prompt treatment is a strategy to avoid ICU oversaturation. There is a consensus that a hyperinflammatory syndrome or a "cytokine storm" is responsible for poor outcomes in COVID-19. Measuring cytokine levels at the point of care is required in order to better understand this process. In this Perspective, we summarize the main events behind the cytokine storm in COVID-19 as well as current experimental treatments. We advocate for a new biosensor-enabled paradigm to personalize the management of COVID-19 and stratify patients. Biosensorguided dosing and timing of immunomodulatory therapies could maximize the benefits of these anti-inflammatory treatments while minimizing deleterious effects. Biosensors will also be essential in order to detect complications such as coinfections and sepsis, which are common in immunosuppressed patients. Finally, we propose the ideal features of these biosensors using some prototypes from the recent literature as examples. Multisensors, lateral flow tests, mobile biosensors, and wearable biosensors are seen as key players for precision medicine in COVID-19.

COVID-19: In the Eye of the Cytokine Storm

“…In turn, this could be used for guiding the timing and dosage of antiinflammatory treatments, as well as to assess their effectiveness. Point-of-care diagnostic devices will likely be crucial to enable these kinetic biomarker measurements without collapsing central diagnosis laboratories (74)(75)(76)(77).…”

Electrochemical SARS-CoV-2 Sensing at Point-of-Care and Artificial Intelligence for Intelligent COVID-19 Management

“… 31 , 54 − 56 Among them, investigating sensitive, selective, and affordable analytical COVID-19 tools to detect SARS-CoV-2 are in demand to perform targeted and mass COVID-19 diagnostics. 41 , 57 The aspects and advancements in the field of developing sensing strategies to detected SARS-CoV-2 are discussed in the next section.…”

Nano- and biosensors for the detection of SARS-CoV-2: challenges and opportunities

“…Application of biosensors for constantly evaluation of cytokine levels have demonstrated remarkable potentials for diagnosis of COVID-19 progression/severity stages and analysis of the efficacy of anti-inflammatory treatments. 13 For instance, needle-shaped microelectrodes were suggested for identification of changes in Interleukin-6 (IL-6) levels in real time. 12 Additionally, by applying aptamer-modified graphene as the conducting channel, a wearable and deformable graphene-based field-effect transistor biosensor was designed for sensitive, consistent and timeresolved detection of cytokines in human biofluids (Figure 7).…”

“…Some important diagnostic methods for detection of SARS-CoV-2 are summarized in Figure 2. [11][12][13] Currently, COVID-19 detection is mainly based on the combination of some techniques which include RT-PCR, chest X-ray, CT scans, and identification of some main biomarkers in the blood; the detection of the level of biomarkers, including procalcitonin (low level), C-reactive protein (elevated level), lymphocyte counts (low level), and interleukins 6 and 10 (high concentrations)…”

“…) 52. It appears that biosensors should still be further evaluated and developed for clinical applications; wearable biosensors are promising candidates for continuous monitoring and follow up of patients with COVID-19 13. Creative Commons Attribution-NonCommercial 3.0 Unported Licence.…”