Targeting complement in severe coronavirus disease 2019 to address microthrombosis

Abstract

There is no approved therapy for coronavirus disease 2019 [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection], and the number of worldwide deaths on current standard therapy is staggering Current therapy is aimed at decreasing viral replication, supporting vital functions and addressing the most damaging consequences of the disease such as hyperinflammation (the so-called cytokine storm) and thrombosis. The latter two involve the use of anti-inflammatory therapies and heparin, respectively. We suggest that complement-blocking strategies such as eculizumab should be considered in severe cases not responding well to current therapy, including tocilizumab, in the context of clinical trials. Complement is thought to contribute to microangiopathies associated with infectious diseases