COVID-19 Updates: New Study Shows That Large Percentage Of Severe COVID-19 Patients Do Not Have Cytokine Storms, Contradicting Earlier Assumptions!
: A new study by researchers from Massachusetts General Hospital, Icahn School of Medicine, Cohen Children's Medical Center, University of California-San Francisco, Hutchinson Cancer Research Center, University of Pennsylvania and Zucker School of Medicine at Hofstra-Northwell, Hempstead has shown that contrary what was earlier assumed, may severe COVID-19 patients do not manifest cytokine storms.
The assumption of so-called cytokine storm in patients with COVID-19 has prompted consideration of anti-cytokine therapies, particularly interleukin-6 antagonists.
Interestingly however, direct systematic comparisons of COVID-19 with other critical illnesses associated with elevated cytokine concentrations have not been reported.
In this meta-analytical study, the study team report the results of a systematic review and meta-analysis of COVID-19 studies published between Nov 1, 2019, and April 14, 2020, in which interleukin-6 concentrations in patients with severe or critical disease were recorded.
A total of 25 COVID-19 studies (n=1245 patients) were ultimately included. Comparator groups included four trials each in sepsis (n=5320), cytokine release syndrome (n=72), and acute respiratory distress syndrome unrelated to COVID-19 (n=2767).
Significantly in patients with severe or critical COVID-19, the pooled mean serum interleukin-6 concentration was 36·7 pg/mL (95% CI 21·6–62·3 pg/mL; I
2=57·7%). Mean interleukin-6 concentrations were nearly 100 times higher in patients with cytokine release syndrome (3110·5 pg/mL, 632·3–15 302·9 pg/mL; p<0·0001), 27 times higher in patients with sepsis (983·6 pg/mL, 550·1–1758·4 pg/mL; p<0·0001), and 12 times higher in patients with acute respiratory distress syndrome unrelated to COVID-19 (460 pg/mL, 216·3–978·7 pg/mL; p<0·0001).
The study findings question the role of a cytokine storm in COVID-19-induced organ dysfunction. Many questions remain about the immune features of COVID-19 and the potential role of anti-cytokine and immune-modulating treatments in patients with the disease.
The study findings were published in the journal: The Lancet Respiratory Medicine. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30404-5/fulltext#%20
Dr Daniel E. Leisman, M.D., from Massachusetts General Hospital in Boston, led the systematic review
and meta-analysis of the COVID-19 studies published.
Dr Leisman told Thailand Medical News, "Our findings question the role of a cytokine storm in COVID-19-induced organ dysfunction. Many questions remain about the immune features of COVID-19 and the potential role of anticytokine and immune-modulating treatments in patients with the disease."
From a Thailand Medical News perspective, not only has the whole COVID-19 pandemic been badly managed but the medical community has been treating COVID19 wrongly and has
been basing clinical treatments and care on the findings of earlier substandard research findings.
The COVID-19 disease has to be approached from a personalized and precision approach beginning with the identification of the strains affecting an individual, to the genetic profile of the patient and the results of a wide range of diagnostic tests to see the status of these biomarkers in the patient and also to consider other factors including existing comorbidities, age, sex and previous pathogenic infections etc.
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