Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

Fara, Antonella F.; Mitrev, Zan; Rosalia, Rodney Alexander; Assas, Bakri M.

doi:10.1098/rsob.200160

Cited by 288 publications

(259 citation statements)

References 140 publications

(203 reference statements)

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“…This event can result in organ failure and death [ 84 ]. Cytokine storm has also been reported in previous cases of SARS-CoV-1 as well [ 82 ].…”

Section: Sars-cov-2 Mediates Immune Cell Infiltration Cytokine Stormmentioning

confidence: 64%

“…Receptor-ligand interactions among the cells that have been compromised with the virus occur which produce a positive feedback loop activating more white blood cells, which in turn starts a cascade which releases pro-inflammatory cytokines that can spread throughout the entire body. Some SARS-CoV-2 patients can experience this phenomenon and present with mild to severe cold-like symptoms that include respiratory issues and a general feeling of fatigue [ 82 , 83 ]. Several cytokines are believed to mediate this reaction to include tumor necrosis factor (TNF), chemokines, IL’s, IFN, colony-stimulating factors (CSF), growth factors, and other molecules.…”

Section: Sars-cov-2 Mediates Immune Cell Infiltration Cytokine Stormmentioning

confidence: 99%

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SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders

Amruta

Chastain

Paz

et al. 2021

Cytokine & Growth Factor Reviews

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“…This event can result in organ failure and death [ 84 ]. Cytokine storm has also been reported in previous cases of SARS-CoV-1 as well [ 82 ].…”

Section: Sars-cov-2 Mediates Immune Cell Infiltration Cytokine Stormmentioning

confidence: 64%

Section: Sars-cov-2 Mediates Immune Cell Infiltration Cytokine Stormmentioning

confidence: 99%

SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders

Amruta

Chastain

Paz

et al. 2021

Cytokine & Growth Factor Reviews

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“…The serum levels of hs-CRP, IL-6 and TNF-α were measured on day 1, after randomization and commencement of treatment, and on day 7. Increase in hs-CRP,IL-6 and TNF-α in response to SARS-CoV-2 infection is indicative of the severity of disease prognosis ( Del Valle et al, 2020 ; Fara et al, 2020 ; Sharifpour et al, 2020 ). Average serum level of hs-CRP was significantly increased in the placebo group on day 7 compared to day 1.…”

Section: Resultsmentioning

confidence: 99%

“…The cytokine release syndrome, resulting from robust immune activation, leads to multiorgan dysfunction and death ( Del Valle et al, 2020 ). Inflammatory markers, like, IL-6, TNF-α and hs-CRP are used as predictors for risk stratification of COVID-19 cases ( Del Valle et al, 2020 ; Fara et al, 2020 ; Sharifpour et al, 2020 ). Anti-IL-6 antibodies, like, tocilizumab, is being used to treat severe SARS-CoV-2 infections ( Guaraldi et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Randomized placebo-controlled pilot clinical trial on the efficacy of ayurvedic treatment regime on COVID-19 positive patients

et al. 2021

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Background Specific treatment for COVID-19 is still an unmet need. Outcomes of clinical trials on repurposed drugs have not been yielding success. Therefore, it is necessary to include complementary approaches of medicine against COVID-19. Purpose This study was designed to evaluate the impact of traditional Indian Ayurvedic treatment regime on asymptomatic patients with COVID-19 infection. Study design It is a placebo controlled randomized double-blind pilot clinical trial. Methods The study was registered with Clinical Trial Registry-India (vide Registration No. CTRI/2020/05/025273) and conducted at the Department of Medicine in National Institute of Medical Sciences and Research, Jaipur, India. 1 g of Giloy Ghanvati ( Tinospora cordifolia ) and 2 g of Swasari Ras (traditional herbo-mineral formulation) and 0.5 g each of Ashwagandha ( Withania somnifera ) and Tulsi Ghanvati ( Ocimum sanctum ) were given orally to the patients in treatment group twice per day for 7 days. Medicines were given in the form of tablets and each tablet weighed 500 mg. While, Swasari Ras was administered in powdered form, 30 min before breakfasts and dinners, rest were scheduled for 30 min post-meals. Patients in the treatment group also received 4 drops of Anu taila (traditional nasal drop) in each nostril every day 1 h before breakfast. Patients in the placebo group received identical-looking tablets and drops, post randomization and double blinded assortments. RT-qPCR test was used for the detection of viral load in the nasopharyngeal and oropharyngeal swab samples of study participants during the study. Chemiluminescent immunometric assay was used to quantify serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and high sensitivity C-reactive protein (hs-CRP) on day 1 and day 7 of the study. Results By day 3, 71.1 % and 50.0 % patients recovered in the treatment and placebo groups, respectively. Treatment group witnessed 100% recovery by day 7, while it was 60.0 % in the placebo group. Average fold changes in serum levels of hs-CRP, IL-6 and TNF-α in treatment group were respectively, 12.4, 2.5 and 20 times lesser than those in the placebo group at day 7. There was 40% absolute reduction in the risk of delayed recovery from infection in the treatment group. Conclusions Ayurvedic treatment can expedite virological clearance, help in faster recovery and concomitantly reduce the risk of viral dissemination. Reduced inflammation markers suggested less severity of SARS-CoV-2 infection in the treatment group. Moreover, there was no adverse effect observed to be associated with this treatment.

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“…Anti-inflammatory therapies are, for instance, being considered in multidisciplinary approaches to halt hyper-inflammatory responses that would otherwise deadly incite COVID-19 progression, and many efforts are being paid to test molecules like anti-cytokine biologicals and disease-modifying antirheumatic drugs (DMARDs) [ 45 , 46 ]. While there is a general consensus that drugs with anti-inflammatory/immunomodulatory effects can potentially disrupt the self-perpetrating loop that dictates the transition from mild to severe form of COVID-19 [ 47 , 48 ], we are still on the road to figuring out which therapeutic approaches are best according to patients’ conditions [ 31 , 49 , 50 , 51 ]. For instance, molecules that target specific inflammatory pathways would be clinically relevant only if they timely hit on major signals among the redundant drivers of inflammatory storm caused by SARS-CoV-2 infection.…”

Section: Introductionmentioning

confidence: 99%

Challenges and Opportunities from Targeting Inflammatory Responses to SARS-CoV-2 Infection: A Narrative Review

Lariccia

Magi

Serfilippi

et al. 2020

JCM

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The novel coronavirus disease 2019 (COVID-19) is a global pandemic that continues to sweep across the world, posing an urgent need for effective therapies and prevention of the spread of the severe acute respiratory syndrome related to coronavirus-2 (SARS-CoV-2). A major hypothesis that is currently guiding research and clinical care posits that an excessive and uncontrolled surge of pro-inflammatory cytokines (the so-called “cytokine storm”) drives morbidity and mortality in the most severe cases. In the overall efforts made to develop effective and safe therapies (including vaccines) for COVID-19, clinicians are thus repurposing ready-to-use drugs with direct or indirect anti-inflammatory and immunomodulatory activities. Speculatively, there are many opportunities and challenges in targeting immune/inflammatory processes in the evolving settings of COVID-19 disease because of the need to safely balance the fight against virus and aggressive inflammation versus the suppression of host immune defenses and the risk of additional harms in already compromised patients. To this end, many studies are globally underway to weigh the pros and cons of tailoring drugs used for inflammatory-driven conditions to COVID-19 patient care, and the next step will be to summarize the growing clinical trial experience into clean clinical practice. Based on the current evidence, anti-inflammatory drugs should be considered as complementary approaches to anti-viral drugs that need to be timely introduced in the management of COVID-19 according to disease severity. While drugs that target SARS-CoV-2 entry or replication are expected to confer the greatest benefits at the early stage of the infection, anti-inflammatory drugs would be more effective in limiting the inflammatory processes that drive the worsening of the disease.

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Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

Cited by 288 publications

References 140 publications

SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders

SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders

Randomized placebo-controlled pilot clinical trial on the efficacy of ayurvedic treatment regime on COVID-19 positive patients

Challenges and Opportunities from Targeting Inflammatory Responses to SARS-CoV-2 Infection: A Narrative Review

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