Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)?

Bingwen Liu, Min Li, Zhiguang Zhou, Xuan Guan, Yufei Xiang, Bingwen Liu, Min Li, Zhiguang Zhou, Xuan Guan, Yufei Xiang

Abstract

The emergent outbreak of coronavirus disease 2019 (COVID-19) has caused a global pandemic. Acute respiratory distress syndrome (ARDS) and multiorgan dysfunction are among the leading causes of death in critically ill patients with COVID-19. The elevated inflammatory cytokines suggest that a cytokine storm, also known as cytokine release syndrome (CRS), may play a major role in the pathology of COVID-19. However, the efficacy of corticosteroids, commonly utilized antiinflammatory agents, to treat COVID-19-induced CRS is controversial. There is an urgent need for novel therapies to treat COVID-19-induced CRS. Here, we discuss the pathogenesis of severe acute respiratory syndrome (SARS)-induced CRS, compare the CRS in COVID-19 with that in SARS and Middle East respiratory syndrome (MERS), and summarize the existing therapies for CRS. We propose to utilize interleukin-6 (IL-6) blockade to manage COVID-19-induced CRS and discuss several factors that should be taken into consideration for its clinical application.

Keywords: Coronavirus disease 2019; Cytokine release syndrome; Interleukin-6; Tocilizumab.

Conflict of interest statement

Declaration of competing interest No potential conflicts of interest relevant to this review were reported.

Copyright © 2020 Elsevier Ltd. All rights reserved.

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