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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.

            Content

            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
            87ca94ec-18e4-4f95-967e-a025c3fab240

            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
            None No Grants were used for this investigation

            Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
            Nephrology,Infectious disease & Microbiology
            coronavirus,cytokine,hemofiltration,adsorption,corticosteroid,immunomodulation,cytokine storm,IL-6

            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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