After having reviewed the structural details of covid 19 virus and presentation we updated on the newer insight on the virus with regard to effective therapy. Simultaneously we tried to update on the pathophysiology with HAPE hypothesis needing changes in approach regarding no immediate intubation and rather preferable ventilation with O2 alone [1,2]. Further we emphasized on regards to cytokine release syndrome (CRS) development and thrombosis development in etiopathogenesis of severe acute respiratory distress syndrome (ARDS) along with management during pregnancy and lactation [3].

References

1. Kulvinder Kochar Kaur., et al. “A Comprehensive review on epidemiology, aetiopathogenesis, diagnosis and treatment of the novel corona virus syndrome –COVID-19’’ Iberoamerican Journal Of Medicine 2 (2020): 110-123.
2. Kulvinder Kochar Kaur. “Editorial-Maximum possible efforts by which we will win over this Deadly Pandemic of COVID-19’’. Acta Scientific Microbiology6 (2020): 01-03.
3. Kulvinder Kochar Kaur., et al. “An Update on COVID19 from Etiopathogenesis, to role in male infertility, Pregnancy Lactation, and Regarding treatment” (2020).
4. Moore JB and June CH. “Cytokine release syndrome in severe COVID-19”. Science (2020).
5. Chen G., et al. “Clinical and immunological features of severe and moderate coronavirus disease 2019”. Journal of Clinical Investigation (2020).
6. Ruan Q., et al. “Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China”. Intensive Care Medicine (2020).
7. Wu Z and McGoogan JM. “Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention”. The Journal of the American Medical Association (2020).
8. Kang S., et al. “Targeting Interleukin-6 Signaling in Clinic”. Immunity4 (2019): 1007-1023.
9. Xu Z., et al. “Pathological findings of COVID-19 associated with acute respiratory distress syndrome”. The Lancet Respiratory Medicine (2020).
10. Miossec P and Kolls JK. “Targeting IL-17 and TH17 cells in chronic inflammation”. Nature Reviews Drug Discovery 11 (2012): 763-776.
11. Qu D., et al. “IL-6 in diabetes and cardiovascular complications”. British Journal of Pharmacology 171 (2014): 3595-3603.
12. Grupp SA., et al. “Chimeric antigen receptor-modified T cells for acute lymphoid leukemia”. The New England Journal of Medicine 368 (2013): 1509-1518.
13. Winkler U., et al. “Cytokine-release syndrome in patients with B-cell chronic lymphocytic leukemia and high lymphocyte counts after treatment with an anti-CD20 monoclonal antibody (rituximab, IDEC-C2B8)”. Blood 94 (1999): 2217-2224.
14. Genentech, Inc. Prescribing information. ACTEMRA® (tocilizumab) injection, for intravenous or subcutaneous use. South San Francisco, CA: Genentech, Inc. (2019).
15. Xu XL., et al. “Effective treatment of severe COVID-19 patients with tocilizumab”. Pediatric Acute-onset Neuropsychiatric Syndrome (2020).
16. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team the epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China [in Chinese]”. Zhonghua Liu Xing Bing Xue Za Zhi 41 (2020): 145-151.
17. Giles JT., et al. “Cardiovascular safety of tocilizumab versus etanercept in rheumatoid arthritis: a randomized controlled trial”. Arthritis and Rheumatology 72 (2020): 31-40.
18. Kim SC., et al. “Cardiovascular safety of tocilizumab versus tumor necrosis factor inhibitors inpatients with rheumatoid arthritis: a multi-database cohort study”. Arthritis and Rheumatology 69 (2017): 1154-1164.
19. Xie F., et al. “Tocilizumab and the risk of cardiovascular disease: direct comparison among biologic disease-modifying drugs for antirheumatic drugs for rheumatoid arthritis patients”. Arthritis Care and Research 71 (2019): 1004-1018.
20. , et al. “Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality”. International Journal of Antimicrobial Agents 55 (2020): 105954.
21. Dimopoulos G. “Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis”. Cell Host and Microbe 28 (2020): 1-7.
22. Rilinger J., et al. “A prospective, randomised, double blind placebo-controlled trial to evaluate the efficacy and safety of tocilizumab in patients with severe COVID-19 pneumonia (TOC-COVID): A structured summary of a study protocol for a randomised controlled trial”. Trials 1 (2020): 470.
23. , et al. “Treatment of severely III COVID-19 patients with anti-interleukin drugs (COV-AID): A Structured Summary of a study protocol for a randomized controlled trial”. Trials 21.1 (2020): 468.
24. Gorman E., et al. “Repair of Acute Respiratory Distress Syndrome by Stromal Cell Administration in COVID-19 (REALIST-COVID-19): A Structured Summary of a Study Protocol for a Randomised, Controlled Trial”. Trials1 (2020): 462.

Citation

Citation: Kulvinder Kochar Kaur., et al. “Editorial-An Update on Management of Severe COVID19 Presenting with Cytokine Release Syndrome Responsible for Most Mortalities in COVID19". Acta Scientific Microbiology 3.8 (2020): 01-06.

Copyright

Copyright: © 2020 Kulvinder Kochar Kaur., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.