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Title: The role of IL-6 and other mediators in the cytokine storm associated with SARS-CoV-2 infection.
Austin Authors: Copaescu, Ana ;Smibert, Olivia C ;Gibson, Andrew;Phillips, Elizabeth J;Trubiano, Jason A 
Affiliation: Centre for Antibiotic Allergy and Research
Infectious Diseases
Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
Department of Infectious Diseases, Vanderbilt University Medical Centre, Nashville, Tenn, USA
Department of Oncology, Sir Peter MacCallum Cancer Centre, The University of Melbourne, Parkville, Australia
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, Australia
Medicine (University of Melbourne)
Issue Date: Sep-2020 2020-09
Publication information: The Journal of Allergy and Clinical Immunology 2020; 146(3): 518-534.e1
Abstract: The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 presents with a spectrum of clinical manifestations from asymptomatic or mild, self-limited constitutional symptoms to a hyperinflammatory state ("cytokine storm") followed by acute respiratory distress syndrome and death. The objective of this study was to provide an evidence-based review of the associated pathways and potential treatment of the hyperinflammatory state associated with severe acute respiratory syndrome coronavirus 2 infection. Dysregulated immune responses have been reported to occur in a smaller subset of those infected with severe acute respiratory syndrome coronavirus 2, leading to clinical deterioration 7 to 10 days after initial presentation. A hyperinflammatory state referred to as cytokine storm in its severest form has been marked by elevation of IL-6, IL-10, TNF-α, and other cytokines and severe CD4+ and CD8+ T-cell lymphopenia and coagulopathy. Recognition of at-risk patients could permit early institution of aggressive intensive care and antiviral and immune treatment to reduce the complications related to this proinflammatory state. Several reports and ongoing clinical trials provide hope that available immunomodulatory therapies could have therapeutic potential in these severe cases. This review highlights our current state of knowledge of immune mechanisms and targeted immunomodulatory treatment options for the current coronavirus disease 2019 pandemic.
DOI: 10.1016/j.jaci.2020.07.001
PubMed URL: 32896310
Type: Journal Article
Subjects: COVID-19
cytokine storm
hemophagocytic lymphohistiocytosis
Appears in Collections:Journal articles

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