COVID-19: consider cytokine storm syndromes and immunosuppression

TLDR

COVID‑19 has infected over 125,000 people worldwide with a mortality of about 3.7%, higher than influenza, and evidence suggests that severe cases may involve a cytokine‑storm syndrome, underscoring an urgent need for effective treatments. The authors propose to identify and treat hyperinflammation in COVID‑19 patients using existing, approved therapies. They recommend employing these proven‑safety therapies to rapidly reduce rising mortality.

Abstract

As of March 12, 2020, coronavirus disease 2019 (COVID-19) has been confirmed in 125 048 people worldwide, carrying a mortality of approximately 3·7%,1 compared with a mortality rate of less than 1% from influenza. There is an urgent need for effective treatment. Current focus has been on the development of novel therapeutics, including antivirals and vaccines. Accumulating evidence suggests that a subgroup of patients with severe COVID-19 might have a cytokine storm syndrome. We recommend identification and treatment of hyperinflammation using existing, approved therapies with proven safety profiles to address the immediate need to reduce the rising mortality.