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Cytokine storms, evolution and COVID-19

Joe Alcock1, Alix Masters2

  • 1Department of Emergency Medicine, MSC11 6025 1, University of New Mexico, Albuquerque, NM 87131, USA.

Evolution, Medicine, and Public Health
|September 23, 2021
PubMed

Insights

Corticosteroids are the only effective treatment for cytokine storms in COVID-19. Historical data shows experimental therapies for cytokine storms in other infections have largely failed, informing expectations for new COVID-19 treatments.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Evolutionary Medicine

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has highlighted the critical role of the host immune system in disease pathogenesis.
  • The "cytokine storm" phenomenon, an overactive immune response, is a key driver of severe illness in coronavirus disease 2019 (COVID-19).
  • Intense research has focused on medical interventions targeting the host immune response during COVID-19.

Purpose of the Study:

  • To review the history of experimental therapies for cytokine storms in various infections.
  • To frame expectations for novel interventions aimed at treating COVID-19 cytokine storms.
  • To apply an evolutionary medicine perspective to understanding and treating cytokine storms.

Main Methods:

  • Literature review of historical experimental therapies for cytokine storms.
  • Analysis of treatment outcomes in severe sepsis and other infections.
  • Synthesis of historical data with current COVID-19 research.

Main Results:

  • Corticosteroids are the only class of medication currently proven effective for managing COVID-19 cytokine storms.
  • Numerous experimental therapies for cytokine storms in severe sepsis and other infections have historically failed to improve patient outcomes.
  • Past therapeutic failures provide a cautionary framework for evaluating new COVID-19 treatments.

Conclusions:

  • The historical track record of cytokine storm treatments suggests caution regarding novel therapeutic approaches for COVID-19.
  • An evolutionary medicine perspective may offer insights into the persistence and treatment of hyperinflammatory responses.
  • Understanding the history of cytokine storm treatment is crucial for developing effective strategies against SARS-CoV-2 and future infectious threats.
Keywords:
Covid-19SARS-CoV-2corticosteroidscytokine stormimmunity

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