COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs
COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs
In the Wuhan Province of China, in December 2019, the novel coronavirus 2019 (COVID-19) has caused a severe involvementof the lower respiratory tract leading to an acute respiratory syndrome. Subsequently, coronavirus 2 (SARS-CoV-2) provoked apandemic which is considered a life-threatening disease. The SARS-CoV-2, a family member of betacoronaviruses, possesses singlestrandedpositive-sense RNA with typical structural proteins, involving the envelope, membrane, nucleocapsid and spike proteinsthat are responsible for the viral infectivity, and nonstructural proteins. The effectual host immune response including innate andadaptive immunity against SARS-Cov-2 seems crucial to control and resolve the viral infection. However, the severity and outcomeof the COVID-19 might be associated with the excessive production of proinflammatory cytokines “cytokine storm” leading to anacute respiratory distress syndrome. Regretfully, the exact pathophysiology and treatment, especially for the severe COVID-19, isstill uncertain. The results of preliminary studies have shown that immune-modulatory or immune-suppressive treatments such ashydroxychloroquine, interleukin (IL)-6 and IL-1 antagonists, commonly used in rheumatology, might be considered as treatmentchoices for COVID-19, particularly in severe disease. In this review, to gain better information about appropriate anti-inflammatorytreatments, mostly used in rheumatology for COVID-19, we have focused the attention on the structural features of SARS-CoV-2, thehost immune response against SARS-CoV-2 and its association with the cytokine storm.
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