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A guide to immunotherapy for COVID-19.
van de Veerdonk, Frank L; Giamarellos-Bourboulis, Evangelos; Pickkers, Peter; Derde, Lennie; Leavis, Helen; van Crevel, Reinout; Engel, Job J; Wiersinga, W Joost; Vlaar, Alexander P J; Shankar-Hari, Manu; van der Poll, Tom; Bonten, Marc; Angus, Derek C; van der Meer, Jos W M; Netea, Mihai G.
  • van de Veerdonk FL; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands. frank.vandeveerdonk@radboudumc.nl.
  • Giamarellos-Bourboulis E; Department of Infectious Diseases, Attikon Hospital, University of Athens, Athens, Greece.
  • Pickkers P; Department of Intensive Care Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Derde L; Department of Intensive Care, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Leavis H; Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands.
  • van Crevel R; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Engel JJ; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Wiersinga WJ; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Vlaar APJ; Division of Infectious Diseases, Center for Experimental Molecular Medicine (CEMM), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Shankar-Hari M; Department of Intensive Care Medicine and Laboratory of Experimental Intensive Care Medicine and Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • van der Poll T; School of Immunobiology and Microbial Sciences, King's College London, London, UK.
  • Bonten M; Division of Infectious Diseases, Center for Experimental Molecular Medicine (CEMM), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Angus DC; Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands.
  • van der Meer JWM; UPMC and University of Pittsburgh, Pittsburgh, PA, United States.
  • Netea MG; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
Nat Med ; 28(1): 39-50, 2022 01.
Article in English | MEDLINE | ID: covidwho-1641982
ABSTRACT
Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in clinical decision-making arise from the complexity of the disease phenotypes and patient heterogeneity, as well as the variable quality of evidence from immunotherapy studies. This Review aims to support clinical decision-making by providing an overview of the evidence generated by major clinical trials of host-directed therapy. We discuss patient stratification and propose an algorithm to guide the use of immunotherapy strategies in the clinic. This will not only help guide treatment decisions, but may also help to design future trials that investigate immunotherapy in other severe infections.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein Kinase Inhibitors / Complement Inactivating Agents / Immunomodulation / COVID-19 / Glucocorticoids / Immunologic Factors / Anticoagulants Type of study: Prognostic study Limits: Humans Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2022 Document Type: Article Affiliation country: S41591-021-01643-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein Kinase Inhibitors / Complement Inactivating Agents / Immunomodulation / COVID-19 / Glucocorticoids / Immunologic Factors / Anticoagulants Type of study: Prognostic study Limits: Humans Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2022 Document Type: Article Affiliation country: S41591-021-01643-9