The role of cytokines and their antagonists in the treatment of COVID-19 patients

Zeinab Mohseni Afshar; Mohammad Barary; Arefeh Babazadeh; Ali Tavakoli Pirzaman; Rezvan Hosseinzadeh; Amirmasoud Alijanpour; Amirreza Allahgholipour; Seyed Rouhollah Miri; Terence T Sio; Mark J M Sullman; Kristin Carson-Chahhoud; Soheil Ebrahimpour

doi:10.1002/rmv.2372

The role of cytokines and their antagonists in the treatment of COVID-19 patients

Rev Med Virol. 2023 Jan;33(1):e2372. doi: 10.1002/rmv.2372. Epub 2022 May 27.

Affiliations

¹ Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
⁴ Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁵ Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
⁶ Faculty of Medicine, Semmelweis University, Budapest, Hungary.
⁷ Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁸ Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Science, Tehran, Iran.
⁹ Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA.
¹⁰ Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.
¹¹ Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.
¹² Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.

Abstract

The coronavirus disease 2019 (COVID-19) has various presentations, of which immune dysregulation or the so-called cytokine storm syndrome (COVID-CSS) is prominent. Even though cytokines are vital regulators of body immunoinflammatory responses, their exaggerated release can be harmful. This hyperinflammatory response is more commonly observed during severe COVID-19 infections, caused by the excessive release of pro-inflammatory cytokines, such as interleukin-1 (IL-1), IL-6, IL-8, tumour necrosis factor, granulocyte-macrophage colony-stimulating factor, and interferon-gamma, making their blockers and antagonists of great interest as therapeutic options in this condition. Thus, the pathophysiology of excessive cytokine secretion is outlined, and their most important blockers and antagonists are discussed, mainly focussing on tocilizumab, an interleukin-6 receptor blocker approved to treat severe COVID-19 infections.

Keywords: COVID-19; SARS-CoV-2; cytokine; tocilizumab.

Publication types

Review

MeSH terms

COVID-19*
Cytokines
Humans
SARS-CoV-2

Substances

Cytokines