Cytokine Release Syndrome In COVID-19 Patients

On January 7, 2020, researchers in China isolated and sequenced a new coronavirus called SARS-CoV-2 from patients with severe pneumonitis, which rapidly spread around the world and became a global emergency medical service. 

Typical manifestations are flu-like symptoms such as fever, cough, fatigue and shortness of breath. However, in about 20% of patients, the infection causes severe interstitial pneumonia and can trigger an uncontrolled response to the body's immune response, resulting in a life-threatening condition known as cytokine release syndrome (CRS). There are some websites that provide a multiplex ELISA kit for CRS.

CRS is an emergency, often challenged, a scenario in which the complex and intertwined relationship between infection and autoimmunity is present. Indeed, treatment for CRS involves the use of antiviral agents to control the underlying infection and immunosuppressive agents to control the host's aberrant anti-inflammatory response. 

Several studies are ongoing in patients with COVID-19 and CRS on the safety and effectiveness of immunosuppressants, which are commonly used in rheumatic diseases. Some of them are promising. However, such applications must follow a multidisciplinary approach, be followed by close monitoring, be tailored to the clinical and serological characteristics of the patient, and initiated at the right time for the best results. 

Autoimmune patients who take immunosuppressants can be susceptible to SARS-CoV-2 infection. However, ongoing discontinuation of therapy is contraindicated in order to avoid the aggravation of the disease and an increased risk of infection.