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      Cytokine Removal and Immunomodulation in COVID-19 Severe Pulmonary Respiratory Infection

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          Abstract

          Coronavirus infection produces a cytokine storm in some patients, developing a moderate to severe clinical condition that is associated to increased mortality mainly because of severe pulmonary involvement. Elevated levels of IL-6 have been found in non-survivor patients.

          In these patients, clearance of cytokines with extracorporeal therapies, Pulse High- Volume Hemofiltration together with adsorption columns Cytosorb, in short periods of time for 1 to 3 days, could help remove inflammatory cytokines allowing a downregulation of the inflammatory response; and, at the same time, treatment with low dose steroids, could give an opportunity for the host to reach homeostasis, decreasing lung damage and improving survival.

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          Author and article information

          Journal
          ScienceOpen Preprints
          ScienceOpen
          17 April 2020
          Affiliations
          [1 ] Instituto de Ciencias Médicas, Nefrología
          [2 ] Instituto de Ciencias Médicas, Nefrología
          [3 ] Instituto de Ciencias Médicas, Infectología
          Article
          10.14293/S2199-1006.1.SOR-.PPWLC61.v1

          This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

          Funding

          Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

          Nephrology, Infectious disease & Microbiology

          IL-6, coronavirus, cytokine, hemofiltration, adsorption, corticosteroid, immunomodulation, cytokine storm

          Comments

          This is an interesting review on this novel approach to counteract the cytokine storm produced by coronavirus infection.

          The manuscript describes what is  known about pathophysiology of pulmonar damage and propose novel treatment modalities. As these therapies already have a place in the treatment of kidney failure, from my point of view, mentioning kidney damage, frequently observed in coronavirus infection, would help to increase the interest for this manuscript.

          Undoubtely, there is much to know about this disease, and the intense investigation, which is being performed about it, will give us many answers in the near future. Meanwhile, it is possible that therapeutic approaches such as proposed in this study, would help to save lifes, and are worth to take in account. 

           

          2020-05-10 18:47 UTC
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