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    The role of IL-6 and other mediators in the cytokine storm associated with SARS-CoV-2 infection

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    Author
    Copaescu, A; Smibert, O; Gibson, A; Phillips, EJ; Trubiano, JA
    Date
    2020-09-01
    Source Title
    Journal of Allergy and Clinical Immunology
    Publisher
    MOSBY-ELSEVIER
    University of Melbourne Author/s
    Trubiano, Jason; Smibert, Olivia
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Copaescu, A., Smibert, O., Gibson, A., Phillips, E. J. & Trubiano, J. A. (2020). The role of IL-6 and other mediators in the cytokine storm associated with SARS-CoV-2 infection. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 146 (3), pp.518-+. https://doi.org/10.1016/j.jaci.2020.07.001.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254604
    DOI
    10.1016/j.jaci.2020.07.001
    Open Access URL
    https://europepmc.org/articles/PMC7471766?pdf=render
    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.

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