Abstract
A subset of patients with severe COVID-19 develop profound inflammation and multi-organ dysfunction consistent with a “Cytokine Storm Syndrome” (CSS). In this review we compare the clinical features, diagnosis, and pathogenesis of COVID-CSS with other hematological CSS, namely secondary hemophagocytic lymphohistiocytosis (sHLH), idiopathic multicentric Castleman disease (iMCD), and CAR-T cell therapy associated Cytokine Release Syndrome (CRS). Novel therapeutics targeting cytokines or inhibiting cell signaling pathways have now become the mainstay of treatment in these CSS. We review the evidence for cytokine blockade and attenuation in these known CSS as well as the emerging literature and clinical trials pertaining to COVID-CSS. Established markers of inflammation as well as cytokine levels are compared and contrasted between these four entities in order to establish a foundation for future diagnostic criteria of COVID-CSS.
Keywords: COVID-19; Cytokine release syndrome; Cytokine storm syndrome; Hemophagocytic lymphohistiocytosis; Idiopathic multicentric Castleman disease; Severe acute respiratory syndrome coronavirus −2 (SARS-CoV-2).
【저자키워드】 COVID-19, Cytokine storm syndrome, Cytokine release syndrome, hemophagocytic lymphohistiocytosis, Idiopathic multicentric Castleman disease, Severe acute respiratory syndrome coronavirus −2 (SARS-CoV-2)., 【초록키워드】 Treatment, SARS-CoV-2, Inflammation, Release, coronavirus, clinical trial, Cytokines, Pathogenesis, severe COVID-19, multi-organ dysfunction, Cell therapy, CAR-T, Diagnosis, clinical trials, cytokine, Cytokine storm syndrome, severe acute respiratory syndrome Coronavirus, Clinical features, Cytokine release syndrome, Cell signaling, Patient, attenuation, hemophagocytic lymphohistiocytosis, signaling pathway, novel, respiratory, secondary hemophagocytic lymphohistiocytosis, disease, cytokine levels, marker, CRS, Evidence, Diagnostic Criteria, CAR-T cell therapy, acute respiratory syndrome, foundation, hematological, blockade, idiopathic, storm, sHLH, Cell, develop, subset, inhibiting, CSS, cytokine level, 【제목키워드】 cytokine, cytokine syndrome, lesson, hematologic,