Treatment Options during Cytokine Storm

Abstract

Cytokine storm is the major cause of death in patients with acute respiratory distress caused by COVID-19. Because cytokine storm is a life-threatening condition, it is important to treat patients with the most appropriate drugs depending on their infectious pathogen and medical status. In this short review, we highlight the pharmacological and nonpharmacological options for handling the cytokine storm. The potential drug targets comprise the use of small molecule or large macromolecules. These molecules include antibodies to bind with and inhibit the actions of interleukins, cytokine signal transducers such as Janus Kinases (JAKs), and cytokine receptors such as the cytokine receptor colony-stimulating factor 1 receptor (CSF1R). So far, dexamethasone appeared to be the pharmacological treatment of choice in managing or preventing cytokine release syndrome because of its safety and cost-effectiveness. Other pharmacological options either require more studies to prove their efficacy (e.g., anakinra and solnatide) or have shown poor efficacy in recent studies (e.g., tocilizumab). Moreover, specific immunoadsorption techniques can be safe and effective when considering nonpharmacological treatment.

Keywords

• Cytokine storm
• monoclonal antibodies
• inflammation
• COVID-19