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Published on: September 24, 2020
Complement Inhibition in Severe COVID-19 Acute Respiratory Distress Syndrome
Sharmila Raghunandan1,2, Cassandra D Josephson2,3, Hans Verkerke3
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.
Most children with COVID-19 experience mild illness, but severe cases can cause acute respiratory distress syndrome (ARDS). Complement-mediated lung injury may play a role, as suggested by a case treated with convalescent plasma and eculizumab.
Area of Science:
- Pediatric critical care medicine
- Immunology
- Infectious diseases
Background:
- COVID-19 in children often presents as mild or asymptomatic illness.
- Critically ill children with COVID-19 may develop acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI).
- Lung function deterioration in COVID-19 is associated with microangiopathic and immune-mediated processes, potentially involving complement activation.
Observation:
- The role of complement-mediated acute lung injury is supported by animal models, human autopsy data, and therapeutic responses.
- A case of a child with severe COVID-19 treated with convalescent plasma and eculizumab is presented.
- Detailed evaluation of inflammatory pathways in this case is provided.
Findings:
- Complement inhibition may be a therapeutic target for severe COVID-19 ARDS.
- Understanding inflammatory pathways is crucial for managing critical illness in children.
- Convalescent plasma and eculizumab were used in a pediatric case of severe COVID-19.
Implications:
- This case highlights the potential role of complement in pediatric COVID-19 lung injury.
- Further research into complement-targeted therapies for severe COVID-19 in children is warranted.
- Insights into inflammatory pathways can inform treatment strategies for critical COVID-19.
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