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Pathogenesis and treatment of cytokine storm in COVID-19

Mehmet; Gökhan; Pamir


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    <subfield code="a">&lt;p&gt;COVID-19 is a viral infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that killed a large&amp;nbsp;number of patients around the world. A hyperinflammatory state resulting in a cytokine storm and adult respiratory distress syndrome&amp;nbsp;seems to be the major cause of the death. Many mechanisms have been suggested in the pathogenesis of COVID-19 associated cytokine&amp;nbsp;storm (COVID-CS). Insufficient viral clearance and persistence of a strong cytokine response despite inadequate antiviral immunity&amp;nbsp;seem to be the main mechanisms underlying the pathogenesis. The diagnosis of COVID-19 is based on relatively constant clinical&amp;nbsp;symptoms, clinical findings, laboratory tests, and imaging techniques, while the diagnosis of COVID-CS is a rather dynamic process,&amp;nbsp;based on evolving or newly emerging findings during the clinical course. Management of COVID-19 consists of using antiviral agents&amp;nbsp;to inhibit SARS-CoV-2 replication and treating potential complications including the cytokine storm together with general supportive&amp;nbsp;measures. COVID-CS may be treated using appropriate immunosuppressive and immunomodulatory drugs that reduce the level of&amp;nbsp;inappropriate systemic inflammation, which has the potential to cause organ damage. Currently corticosteroids, IL-6 blockers, or IL-1&amp;nbsp;blockers are most widely used for treating COVID-CS.&lt;/p&gt;</subfield>
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