Cytokine Storms Not Causing Lung Damage from COVID-19

Latest research could change doctors’ treatment strategies regarding cytokine storms

For some time, researchers have believed that acute lung damage in people with COVID-19 is the result of cytokine storms, signals from within the immune system. However, the latest work from Washington University in St. Louis and St. Jude’s Children’s Research Hospital in Memphis, Tenn. suggests this is not the case.

This finding could change the way doctors treat severe infections with the new coronavirus. It could also explain why anti-inflammatory medications only work for a small portion of people with COVID-19.

“One of the very first papers published on COVID-19 patients in China reported high levels of cytokines in people in intensive care — what we might call a cytokine storm,” says the study’s co-lead author Dr. Philip Mudd, MD, PhD, assistant professor of emergency medicine at Barnes-Jewish Hospital.

“We found that cytokine storm does happen, but it’s relatively rare, even in the COVID-19 patients that go on to have respiratory failure and require a ventilator.”

Dr. Mudd says that despite weak evidence, scientists have established the idea that surges in cytokine levels cause respiratory failure in COVID-19. In addition, doctors have started to give anti-inflammatory medications to critically ill COVID-19 patients to prevent cytokine storms.

“That worries me because such treatments are unlikely to help most patients with COVID-19,” he says.

The study appears in the journal Science Advances.

Several studies show that lung failure associated with COVID-19 may be due to cytokine storm syndrome (CSS). Cytokines are cell-signaling molecules that help immune cells communicate. They also stimulate immune cells to move towards areas of infection, inflammation, or injury.

When CSS occurs, the body releases excessive amounts of cytokines, triggering an overblown immune response. In SARS-CoV-2 infections, CSS may cause inflammatory cells to accumulate in the lung and cause damage.

This proposed link has led many doctors to give severely ill COVID-19 patients high doses of anti-inflammatory medications — primarily steroids — to block CSS. In addition, limited trials show high steroid doses may reduce the likelihood of death in a small group of critically ill people with COVID-19.

SOURCE: Medical News Today

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