Immunomodulatory approaches in managing lung inflammation in COVID‐19: A double‐edge sword

Abstract

IntroductionThe novel coronavirus infectious disease 2019 (COVID‐19) which is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has emerged as a gigantic problem. The lung is the major target organ of SARS‐CoV‐2 and some of its variants like Delta and Omicron variant adapted in such a way that these variants can significantly damage this vital organ of the body. These variants raised a few eyebrows as the outbreaks have been seen in the vaccinated population. Patients develop severe respiratory illnesses which eventually prove fatal unless treated early.Main BodyStudies have shown that SARS‐CoV‐2 causes the release of pro‐inflammatory cytokines such as interleukin (IL)‐6, IL‐1β and tumor necrosis factor (TNF)‐α which are mediators of lung inflammation, lung damage, fever, and fibrosis. Additionally, various chemokines have been found to play an important role in the disease progression. A plethora of pro‐inflammatory cytokines “cytokine storm” has been observed in severe cases of SARS‐CoV‐2 infection leading to acute respiratory distress syndrome (ARDS) and pneumonia that may prove fatal. To counteract cytokine storm‐inducing lung inflammation, several promising immunomodulatory approaches are being investigated in numerous clinical trials. However, the benefits of using these strategies should outweigh the risks involved as the use of certain immunosuppressive approaches might lead the host susceptible to secondary bacterial infections.ConclusionThe present review discusses promising immunomodulatory approaches to manage lung inflammation in COVID‐19 cases which may serve as potential therapeutic options in the future and may prove lifesaving.

Association of hypernatremia with mortality in patients with COVID‐19: A systematic review and meta‐analysis

“…SARS-CoV-2 infection induces a cytokine storm (CS) leading to the release of proinflammatory cytokines, such as interleukin (IL)−6, IL-1β, and tumor necrosis factor (TNF)-α, which play an important role in the progression of COVID-19, and the mechanism is mainly related to the interaction between SARS-CoV-2 and immune cells. 26,27 According to research, COVID-19 severity and clinical prognosis are strongly linked to CS. 28 Studies have shown that SARS-CoV-2 can cause damage to the respiratory, neurological, cardiovascular, gastrointestinal, and genitourinary systems of patients, and its most common clinical symptoms include fever, cough, malaise, anorexia, and shortness of breath.…”

“…SARS‐CoV‐2 infection induces a cytokine storm (CS) leading to the release of proinflammatory cytokines, such as interleukin (IL)−6, IL‐1β, and tumor necrosis factor (TNF)‐α, which play an important role in the progression of COVID‐19, and the mechanism is mainly related to the interaction between SARS‐CoV‐2 and immune cells. 26 , 27 According to research, COVID‐19 severity and clinical prognosis are strongly linked to CS. 28…”

Prognostic Factors and Outcomes in Advanced Stage Lung Cancer Patients with COVID-19 Omicron Variant Infection

“…Studies have shown that SARS-CoV-2 causes the release of pro-inflammatory cytokines such as interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α, which are mediators of lung inflammation, lung damage, fever, and fibrosis; various chemokines have been found to play an important role in disease progression. 13 …”

The mRNA-LNP vaccines – the good, the bad and the ugly?

“…The effectiveness of these therapeutics in preventing infections and limiting the spreading of the virus has been highly eroded from the early reports ( 94 ), and nowadays, their efficacy is mainly limited to potentially decreasing the disease severity and death in susceptible people ( 95 ). Excess inflammation caused by an overreacting immune system (cytokine storm) is one of the major pathological features in patients with severe COVID-19 ( 96 ). Thus, hypothetically, if exposure to the mRNA-LNP vaccine leads to a dampened systemic inflammatory response, that may explain why vaccination also reduced disease severity in the case of the delta and omicron variants, in which case the antibodies induced by the original vaccines were not ( 97 ), or minimally neutralizing ( 98 ).…”