Cytokine storm syndrome in coronavirus disease 2019: A narrative review

Abstract

Cytokine storm syndrome (CSS) is a critical clinical condition induced by a cascade of cytokine activation, characterized by overwhelming systemic inflammation, hyperferritinaemia, haemodynamic instability and multiple organ failure (MOF). At the end of 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged in Wuhan, China, and rapidly developed into a global pandemic. More and more evidence shows that there is a dramatic increase of inflammatory cytokines in patients with COVID‐19, suggesting the existence of cytokine storm in some critical illness patients. Here, we summarize the pathogenesis, clinical manifestation of CSS, and highlight the current understanding about the recognition and potential therapeutic options of CSS in COVID‐19.

Leutragin Inhibits Expression of Cytokines, Including Interleukin-6, in a “Cytokine Storm” Model in C57BL/6Y Mice with Induced Acute Respiratory Distress Syndrome

“…Синдром высвобождения цитокинов, или «цитокиновый шторм», наряду с острым респираторным дистресс-синдромом (ОРДС), лимфопенией и нарушениями свертываемости крови, является одним из ключевых факторов тяжелого течения новой коронавирусной инфекции COVID-19, вызываемой вирусом SARS-CoV-2 [7]. Аномальное повышение уровней цитокинов, в т. ч. интерлейкина-1β (IL-1β), интерлейкина-6 (IL-6), интерлейкина-10 (IL-10), фактора некроза опухоли (TNF-α) и фактора роста эндотелия сосудов (VEGF), ведет к формированию клинической картины системного воспалительного ответа, особую роль в котором играет IL-6 [14,16].…”

Nutraceutical Targeting of Inflammation-Modulating microRNAs in Severe Forms of COVID-19: A Novel Approach to Prevent the Cytokine Storm

“…Over the past years, the cytokine storm has been identified as one of the common events found in critical acute pulmonary syndromes, but also as a key element in the pathogenicity and mortality related to ARDS/ALI following β-SARS-CoV and β-MERS-CoV infections (Gao et al, 2020;Tang et al, 2020). More recently, this cytokine storm has also been reported in severe forms of COVID-19 infection.…”

“…More recently, this cytokine storm has also been reported in severe forms of COVID-19 infection. In CoV infections, the cytokine storm is observed in the later stage of the infection, and is characterized by a rapid and uncontrolled release of several pro-inflammatory cytokines and chemokines by the infected lung tissue, leading to deregulated and excessive immune responses, critical inflammatory self-amplification circles, lung damage and in the more severe cases, mortality (Gao et al, 2020;Tang et al, 2020). Classically, several inflammatory factors are commonly involved in cytokine storm observed in β-SARS-CoV and β-MERS-CoV.…”

“…The cytokine storm associated with severe forms of CoVs infections such as SARS and MERS represents a complex pathological condition involving serious pulmonary complication due to massive recruitment and infiltration of immune cells in pulmonary tissues (Gao et al, 2020;Ye et al, 2020). This can lead to epithelial and endothelial cell death, which in turn causes vascular leakage and ALI.…”

The Opioidergic System of Immune Cells: A New Pharmacological Target in the Therapy of “Cytokine Storm”

“…В настоящей статье мы предлагаем новый фармакологический подход к лечению воспалительных заболеваний, основанный на воздействии на опиоидергическую систему иммуноцитов с целью подавления канонического пути активации NF-κB. По нашему мнению, эта система представляет собой новую, многообещающую фармакологическую мишень в терапии широкого спектра острых и хронических воспалительных заболеваний и в особенности «цитокинового шторма» -жизнеугрожающего состояния, актуальность поиска новых фармакологических подходов к лечению которого растет из-за роста эпидемий вирусных пневмоний и коронавирусной инфекции COVID-19 [1,10,12].…”