Your browser doesn't support javascript.
Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review.
Andaluz-Ojeda, David; Vidal-Cortes, Pablo; Aparisi Sanz, Álvaro; Suberviola, Borja; Del Río Carbajo, Lorena; Nogales Martín, Leonor; Prol Silva, Estefanía; Nieto Del Olmo, Jorge; Barberán, José; Cusacovich, Ivan.
  • Andaluz-Ojeda D; Department of Critical Care, Hospital Universitario HM Sanchinarro, Hospitales Madrid, Madrid 28050, Spain. davidandaluz78@yahoo.es.
  • Vidal-Cortes P; Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain.
  • Aparisi Sanz Á; Department of Cardiology, Hospital del Mar, Barcelona 08003, Spain.
  • Suberviola B; Department of Intensive Care, Hospital Universitario Marqués de Valdecilla, Santander 39008, Spain.
  • Del Río Carbajo L; Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain.
  • Nogales Martín L; Department of Intensive Care, Hospital Clínico Universitario de Valladolid, Valladolid 47005, Spain.
  • Prol Silva E; Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain.
  • Nieto Del Olmo J; Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain.
  • Barberán J; Department of Internal Medicine, Hospital Universitario HM Montepríncipe, Hospitales Madrid, Boadilla del Monte 28860, Madrid, Spain.
  • Cusacovich I; Department of Internal Medicine, Hospital Clínico Universitario de Valladolid, Valladolid 47005, Spain.
World J Crit Care Med ; 11(4): 269-297, 2022 Jul 09.
Article in English | MEDLINE | ID: covidwho-2025162
ABSTRACT

BACKGROUND:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies.

AIM:

To describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of hyperinflammation and abnormal immune responses to disease progression together with a complete narrative review of the different immunoadjuvant treatments used so far in COVID-19 and their indication in severe and life-threatening subsets.

METHODS:

A comprehensive literature search was developed. Authors reviewed the selected manuscripts following the PRISMA recommendations for systematic review and meta-analysis documents and selected the most appropriate. Finally, a recommendation of the use of each treatment was established based on the level of evidence of the articles and documents reviewed. This recommendation was made based on the consensus of all the authors.

RESULTS:

A brief rationale on the SARS-CoV-2 pathogenesis, immune response, and inflammation was developed. The usefulness of 10 different families of treatments related to inflammation and immunopathogenesis of COVID-19 was reviewed and discussed. Finally, based on the level of scientific evidence, a recommendation was established for each of them.

CONCLUSION:

Although several promising therapies exist, only the use of corticosteroids and tocilizumab (or sarilumab in absence of this) have demonstrated evidence enough to recommend its use in critically ill patients with COVID-19. Endotypes including both, clinical and biological characteristics can constitute specific targets for better select certain therapies based on an individualized approach to treatment.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Journal: World J Crit Care Med Year: 2022 Document Type: Article Affiliation country: Wjccm.v11.i4.269

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Journal: World J Crit Care Med Year: 2022 Document Type: Article Affiliation country: Wjccm.v11.i4.269