Adjunct Immunotherapies for the Management of Severely Ill COVID-19 Patients
Adjunct Immunotherapies for the Management of Severely Ill COVID-19 Patients
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DOI：
10.1016/j.xcrm.2020.100016
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发表时间：
2020-05-19
影响因子：
14.3
通讯作者：
Bayry, Jagadeesh
中科院分区：
文献类型：
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作者：
Bonam, Srinivasa Reddy;Kaveri, Srini, V;Bayry, Jagadeesh
2019冠状病毒病（COVID-19）是由严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）引起的。截至2020年5月8日，它已感染了数百万人，死亡病例超过275，000例。目前，没有特定的COVID-19疗法。大多数患者依赖机械通气。目前的COVID-19数据清楚地表明，细胞因子风暴和激活的免疫细胞迁移到肺部是对COVID-19的早期免疫反应的特征，导致严重的肺损伤和急性呼吸窘迫综合征的发展。鉴于与免疫抑制治疗相关的不确定性，如皮质类固醇及其可能的继发性影响，包括继发性感染的风险，我们建议将免疫治疗作为严重COVID-19病例的辅助治疗。这种基于炎性细胞因子中和、免疫调节和被动病毒中和的免疫疗法不仅减少炎症、炎症相关的肺损伤或病毒载量，而且还可以防止重症监护病房住院和对机械通气的依赖，这两者都是有限的资源。
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has infected millions, with more than 275,000 fatal cases as of May 8, 2020. Currently, there are no specific COVID-19 therapies. Most patients depend on mechanical ventilation. Current COVID-19 data clearly highlight that cytokine storm and activated immune cell migration to the lungs characterize the early immune response to COVID-19 that causes severe lung damage and development of acute respiratory distress syndrome. In view of uncertainty associated with immunosuppressive treatments, such as corticosteroids and their possible secondary effects, including risks of secondary infections, we suggest immunotherapies as an adjunct therapy in severe COVID-19 cases. Such immunotherapies based on inflammatory cytokine neutralization, immunomodulation, and passive viral neutralization not only reduce inflammation, inflammationassociated lung damage, or viral load but could also prevent intensive care unit hospitalization and dependency on mechanical ventilation, both of which are limited resources.