The Use of Anti-Inflammatory Drugs in the Treatment of People With Severe Coronavirus Disease 2019 (COVID-19): The Perspectives of Clinical Immunologists From China

Clin Immunol. 2020 May;214:108393. doi: 10.1016/j.clim.2020.108393. Epub 2020 Mar 25.

Abstract

The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system.

Keywords: Anti-inflammation treatment; Coronavirus disease 2019 (COVID-19); Cytokine storm.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Betacoronavirus
  • Chloroquine / therapeutic use
  • Coronavirus Infections / drug therapy*
  • Cytokines / immunology
  • Glucocorticoids / therapeutic use
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Inflammation / pathology
  • Interleukin-6 / antagonists & inhibitors
  • Janus Kinases / antagonists & inhibitors
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Thrombosis / virology
  • Vasculitis / virology

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Cytokines
  • Glucocorticoids
  • Interleukin-6
  • Hydroxychloroquine
  • Chloroquine
  • Janus Kinases
  • tocilizumab

Supplementary concepts

  • COVID-19
  • COVID-19 drug treatment
  • severe acute respiratory syndrome coronavirus 2