Drug Res (Stuttg) 2021; 71(04): 173-179
DOI: 10.1055/a-1291-7692
Review

Macrophage Activation and Cytokine Release Syndrome in COVID-19: Current Updates and Analysis of Repurposed and Investigational Anti-Cytokine Drugs

Ashif Iqubal
1  Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
,
Farazul Hoda
1  Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
,
Abul Kalam Najmi
1  Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
,
Syed Ehtaishamul Haque
1  Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
› Author Affiliations

Abstract

Coronavirus disease (COVID-19) emerged from Wuhan, has now become pandemic and the mortality rate is growing exponentially. Clinical complication and fatality rate is much higher for patients having co-morbid issues. Compromised immune response and hyper inflammation is hall mark of pathogenesis and major cause of mortality. Cytokine release syndrome (CRS) or cytokine storm is a term used to affiliate the situation of hyper inflammation and therefore use of anti-cytokine and anti-inflammatory drugs is used to take care of this situation. Looking into the clinical benefit of these anti-inflammatory drugs, many of them enter into clinical trials. However, understanding the immunopathology of COVID-19 is important otherwise, indiscriminate use of these drugs could be fetal as there exists a very fine line of difference between viral clearing cytokines and inflammatory cytokines. If any drug suppresses the viral clearing cytokines, it will worsen the situation and hence, the use of these drugs must be based on the clinical condition, viral load, co-existing disease condition and severity of the infection.



Publication History

Received: 19 August 2020

Accepted: 13 October 2020

Publication Date:
12 January 2021 (online)

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