Therapeutic options to cytokine release syndrome in patients with COVID-19

Authors

Keywords:

COVID-19, glucocorticoids, inflammation, immunoglobulin's, immunosuppressant's, biological therapy.

Abstract

Without doubt, COVID-19 has attracted the attention of the world population during the year 2020. The rapid spread of the disease, as well as the number of infections, complications and deaths, constitute the main distinctive elements of the disease. The inflammatory process, given by a high production of proinflammatory cytokines, forms the basis of respiratory complications. The objective of this work is to publicize the therapeutic options available to treat cytokine release syndrome. In this sense, it is important to highlight that biological drugs such as tocilizumab, anakinra and roxulitinib, as well as glucocorticoids, intravenous immunoglobulins and some immunosuppressants such as cyclosporin A, are therapeutic options, with theoretical options to combat the inflammatory process in seriously ill patients and which have shown encouraging results in the course of the global health crisis caused by COVID-19. It is concluded that there are therapeutic options to face the storm of proinflammatory cytokines that characterize this syndrome, observed in critically ill patients with this disease. It is now a challenge for scientists and health professionals to identify the right time for therapeutic indications and the algorithm of use, depending on the characteristics of the clinical picture and the patient's health conditions.

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Author Biographies

Urbano Solis Cartas, Universidad Nacional de Chimborazo Escuela Superior politécnica de Chimborazo Hospital Andino de Chimborazo

Especialista de primer Grado en Reumatología.

Jose Pedro Martinez Larrarte, Facultad de Ciencias Médicas 10 de Octubre. La Habana. Cuba

Espeacialista de Segundo Grado en Reumatología.

References

1. Palacios Cruza M, Santos E, Velázquez Cervantes MA, León Juárez M. COVID-19, una emergencia de salud pública mundial. Revista Clínica Española. 2020[acceso: 24/05/2020]:[aprox. 8 p.]. Disponible en: https://www.sciencedirect.com/science/article/pii/S0014256520300928

2. Mendoza Pinto C, García Carrasco M, Munguía Realpozo P, Socorro Mendez Martínez. Opciones Terapéuticas En El Manejo De COVID-19 Grave: Una Perspectiva De Reumatología. Reumatología Clínica. 2020 [acceso: 23/05/2020];258X(20):S1699. Disponible en: https://doi.org/doi:10.1016/j.reuma.2020.05.002

3. Solis Cartas U. Coronavirus y enfermedades reumáticas, suposiciones, mitos y realidades. Rev Cubana de Reumatolo. 2020 [acceso: 24/05/2020];22(2):[aprox. 3 p.]. Disponible en: http://revreumatologia.sld.cu/index.php/reumatologia/article/view/791

4. Parra Izquierdo V, Florez Sarmiento C, Romero Sanchez MC. Inducción de "tormenta de citocinas" en pacientes infectados con SARS- CoV-2 y desarrollo de COVID-19. ¿Tiene el tracto gastrointestinal alguna relación en la gravedad?. Rev Colomb Gastroenterol 2020 [acceso: 23/05//2020];35(Supl. 1):21-9. Disponible en: https://revistagastrocol.com/index.php/rcg/article/view/539

5. Bender del Busto J, León Castellón R, Mendieta Pedroso M. Enfermedad cerebrovascular y COVID-19. Anales de la Academia de Ciencias de Cuba 2020 [acceso: 24/05/2020]; 10(2):[aprox. 5 p.]. Disponible en: http://revistaccuba.sld.cu/index.php/revacc/article/view/802

6. Luo P, Liu Y, Qiu L, Liu X, Liu D, Li J. Tocilizumab treatment in COVID-19: A single center experience. J Med Virol. 2020 [acceso: 22/05/2020];11(2):1-5. Disponible en: https://doi.org/10.1002/jmv.25801

7. Shakoory B, Carcillo JA, Chatham WW, Amdur RL, Zhao H, Dinarello CA, et al. Interleukin-1 Receptor Blockade Is Associated With Reduced Mortality in Sepsis Patients With Features of Macrophage Activation Syndrome: Reanalysis of a Prior Phase III Trial. Crit Care Med. 2016 [acceso: 24/05/2020];44(2):275-81. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26584195/

8. Maschalidi S, Sepulveda FE, Garrigue A, Fischer A, de Saint Basile G. Therapeutic effect of JAK1/2 blockade on the manifestations of hemophagocytic lymphohistiocytosis in mice. Blood. 2016 [acceso: 24/05/2020];128(1):60-71. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27222478/

9. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020 [acceso: 24/05/2020 May 21];323(13):1239-42. Disponible en: https://jamanetwork.com/journals/jama/article-abstract/2762130

10. Reyes Reyes E. Inmunopatogenia en la evolución del paciente grave por la COVID-19. Rev. electron. Zoilo. 2020 [acceso: 23/05/2020];45(3):[aprox. 3 p.]. Disponible en: http://revzoilomarinello.sld.cu/index.php/zmv/article/view/2274

11. Sanchez Pernaute O, Romero Bueno FI, Selva O'Callaghan. ¿Por qué elegir ciclosporina A como primera línea terapéutica para la neumonía causada por COVID-19? Reumatol Clin. 2020 [acceso 24/05/2020]:[aprox. 6 p.]. Disponible en: https://www.reumatologiaclinica.org/es-why-choose-cyclosporin-a-as-avance-S1699258X20300449

12. Jovaisaite V, Mouchiroud L, Auwerx J. The mitochondrial unfolded protein response, a conserved stress response pathway with implications in health and disease.

J Exp Biol, 2014 [acceso: 24/05/2020];217:137-43. Disponible en: https://jeb.biologists.org/content/217/1/137

13. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020. Disponible en: http://dx.doi.org/10.1016/S0140-6736(20)30628-0

14. Zhanga W, Zhao Y, Zhang F, Wang Q, Li T, Liu Z. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China. Clinical Immunology. 2020 [acceso: 23/05/2020];214:108393. Disponible en: https://www.sciencedirect.com/science/article/pii/S1521661620301984

15. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 [acceso: 23/05/2020];323(11):1061-9. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2761044

16. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020[acceso: 23/05/2020]; 15;395(10223):473-5. Disponible en: https://doi.org/10.1016/S0140-6736(20)30317-2

17. Maddur MS, Rabin M, Hegde P, Bolgert F, Guy M, Vallat JM, et al. Intravenous immunoglobulin exerts reciprocal regulation of Th1/Th17 cells and regulatory T cells in Guillain-Barre syndrome patients. Immunol Res. 2014[acceso: 24/05/2020];60(2-3):320-9. Disponible en: https://link.springer.com/article/10.1007/s12026-014-8580-6

18. Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study. Med Rxiv.[Preprint]. 2020 [acceso: 24/05/2020]. Disponible en: https://doi.org/10.1101/2020.03.16.20036145

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Published

2020-08-02

How to Cite

1.
Solis Cartas U, Martinez Larrarte JP. Therapeutic options to cytokine release syndrome in patients with COVID-19. Rev Cubana Med Milit [Internet]. 2020 Aug. 2 [cited 2025 Jan. 30];49(3):e0200783. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/783

Issue

Vol. 49 No. 3 (2020): July - September

Section

Opinion Article

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