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COVID-19 and Multisystem Inflammatory Syndrome, or is it Mast Cell Activation Syndrome?
T C Theoharides1,2,3, P Conti4
1Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston. MA 02111, USA.
Journal of Biological Regulators and Homeostatic Agents
|October 7, 2020
Summary
Long COVID symptoms may resemble Mast Cell Activation Syndrome (MCAS). Evaluating MCAS is crucial for patients with Multisystem Inflammatory Syndrome (MIS) post-COVID-19 infection.
Area of Science:
- Immunology
- Virology
- Pharmacology
Background:
- COVID-19, caused by SARS-CoV-2, can lead to severe lung damage via cytokine storms.
- Many asymptomatic or mild SARS-CoV-2 infections result in persistent, multisystem symptoms months later.
- These post-COVID-19 symptoms mirror those of Multisystem Inflammatory Syndrome in Children (MIS-C) and Adults (MIS-A).
Discussion:
- The symptoms of MIS-C and MIS-A significantly overlap with Mast Cell Activation Syndrome (MCAS).
- MCAS, characterized by idiopathic mast cell activation, presents with similar multisystem inflammatory manifestations.
- Evaluating for MCAS is recommended for patients presenting with MIS or post-COVID-19 multisystem symptoms.
Key Insights:
- Mast cell activation is implicated in the pathogenesis of COVID-19 cytokine storms.
- Luteolin, a liposomal formulation, and rupatadine show potential therapeutic benefits.
- Rupatadine possesses antihistamine and anti-platelet activating factor (PAF) activity, inhibiting mast cells.
Outlook:
- Further research is needed to elucidate the precise mechanisms linking COVID-19, MIS, and MCAS.
- Investigating the efficacy of luteolin and rupatadine in managing post-COVID-19 inflammatory syndromes is warranted.
- Developing targeted therapies for MCAS could offer new treatment avenues for long COVID patients.
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