Last updated March 30, 2020:
Cytokine Storms
It's also good to note that both COVID-19 and the highly pathogenic influenza virus can cause a 'cytokine storm' (the immune cells, macrophages and neutrophils, releasing particles called cytokines to signal to other immune cells to come in to help). This is a hyper-response of the immune system. SARS-CoV also demonstrated immune hyperactivity. Edit: you can check out Dr. Rutland's insta for some more information in immunology.
In veterinary medicine, we have a condition called SIRS (in humans it occurs too, but I have no personal knowledge from it). SIRS, severe inflammatory response syndrome, is essentially that, a cytokine storm. Call the neutrophils "storm troopers" coming in to battle guns blazing with their cytokines in the hundreds of thousands of numbers. It just means massive death and destruction of the infected cells, all at once, causing a gooey matrix. ARDS (acute respiratory distress syndrome) is what occurs in COVID-19. In this regard, treatment for COVID-19 should incorporate anti-viral medications to reduce viral replication, as well as anti-inflammatory measures to slow the hyper-responsiveness of the immune system. This is of course in addition to supportive care with IV fluid therapy, supplemental oxygen and maybe antibiotics to address any secondary bacterial infections.
Anti-inflammatory medications including janus kinase inhibition or blocking of interleukin-6 receptors using monoclonal antibody therapy may be the chosen anti-inflammatory modalities, leaning away from corticosteroids. The anti-malaria medication, hydroxychloroquine, which also has been used in treatment for rheumatoid arthritis - another inflammatory condition, is seeing a wave into the treatment research for COVID-19, likely due to anti-inflammatory properties.
Ultimately, like with most viral diseases, development of a vaccine will be proven to be the most effective measure of preventing infection. Also similar to most other viruses, there will be no one shot cure, only preventative measures (washing your hands after touching people or surfaces that other people have touched) and management of the disease if a person gets infected. If we can lower the R (number of infected individuals infecting other people), slowing the transmission rate, the curve will peak and start to drop. If you neglect to reduce your exposure, then the curve will continue to be exponential. So let’s try to do our part!
For more on COVID-19 issues go to the In The News category
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