Cytokine Storm and its Implication in Coronavirus disease 2019 (COVID-19)

Abstract

Corona virus disease 2019 (COVID-19), is a viral disease caused by novel corona virus known as severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The disease was declared as a pandemic by the World Health Organisation (WHO) on March 11, 2020. Initial studies have shown the molecular resemblances in the receptor binding domains of SARS-CoV and SARS-CoV-2 which bind angiotensin converting enzyme 2 (ACE 2) receptors and helps the virus to enter into the host cells to cause infection. Illness caused by COVID19 ranges from mild common cold to life threatening acute respiratory distress syndrome (ARDS), multi-organ dysfunction and shock. The key step in converting mild disease to severe is immune dysfunction and cytokine dysregulation resulting in “cytokine storm syndrome”. Clinical investigations in patients with COVID-19 have shown that a strong upregulation of cytokine and interferon production is common feature in SARS-CoV2-induced pneumonia, with an associated cytokine storm syndrome. Consequently, spotting of existing approved therapies with proper safety profiles to treat hyperinflammation is very essential in order to reduce COVID-19 associated mortality. Till date, no specific therapeutic drugs or vaccines are available to treat COVID-19. In this review, we intended to describe how cytokine storm is associated with the severity of COVID-19 disease and also tried to find out the best possible way to manage the hyperinflammatory response due to cytokine storm during COVID-19 infection using several interleukin receptor antagonists, inhibitors, intravenous immunoglobulins, cytokine adsorption device and repurposing of pre-existing antiviral and some antimalarial drugs etc. Cytokine Storm and its Implication in Coronavirus disease 2019 (COVID-19)