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The Role of Cytokines including Interleukin-6 in COVID-19 induced Pneumonia and Macrophage Activation Syndrome-Like Disease.
McGonagle, Dennis; Sharif, Kassem; O'Regan, Anthony; Bridgewood, Charlie.
  • McGonagle D; Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, UK. Electronic address: d.g.mcgonagle@leeds.ac.uk.
  • Sharif K; Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK; Sheba Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • O'Regan A; National University of Ireland, Saolta University Healthcare Group, Galway, Ireland.
  • Bridgewood C; Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK.
Autoimmun Rev ; 19(6): 102537, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-52387
ABSTRACT
Severe COVID-19 associated pneumonia patients may exhibit features of systemic hyper-inflammation designated under the umbrella term of macrophage activation syndrome (MAS) or cytokine storm, also known as secondary haemophagocytic lymphohistocytosis (sHLH). This is distinct from HLH associated with immunodeficiency states termed primary HLH -with radically different therapy strategies in both situations. COVID-19 infection with MAS typically occurs in subjects with adult respiratory distress syndrome (ARDS) and historically, non-survival in ARDS was linked to sustained IL-6 and IL-1 elevation. We provide a model for the classification of MAS to stratify the MAS-like presentation in COVID-19 pneumonia and explore the complexities of discerning ARDS from MAS. We discuss the potential impact of timing of anti-cytokine therapy on viral clearance and the impact of such therapy on intra-pulmonary macrophage activation and emergent pulmonary vascular disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Distress Syndrome / Interleukin-6 / Coronavirus Infections / Macrophage Activation Syndrome Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Distress Syndrome / Interleukin-6 / Coronavirus Infections / Macrophage Activation Syndrome Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2020 Document Type: Article