Cytokine Release Syndrome in Severe COVID 19: Lessons From Arthritis and Cell Therapy in Cancer Patients Point to Therapy for Severe Disease
Journal Article - Open Access
WALTER REED NATIONAL MILITARY MEDICAL CENTER BETHESDA MD BETHESDA United States
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In December 2019, a new strain of coronavirus, severe acute respiratory syndrome-coronavirus 2 SARS-CoV-2, was recognized to have emerged in Wuhan, China. Along with SARS-CoV and Middle East respiratory syndrome-coronavirus MERS-CoV, SARS-CoV-2 is the third coronavirus to cause severe respiratory illness in humans, called coronavirus disease 2019COVID-19. This was recognized as a pandemic by the World Health OrganizationWHO in March 2020 and has had considerable global economic and health impacts. Although the situation is rapidly evolving, severe disease manifested by fever and pneumonia, leading to acute respiratory distress syndrome ARDS, has been described in up to 20 of COVID-19 cases. This is reminiscent of cytokine release syndrome CRSinduced ARDS and secondary hemophagocytic lymphohistiocytosis sHLH observed in patients with SARS-CoV and MERS-CoV as well as in leukemia patients receiving engineered T cell therapy. Given this experience, urgently needed therapeutics based on suppressing CRS, such as tocilizumab, have entered clinical trials to treat COVID-19.
- Medicine and Medical Research