COVID-19 and cytokine storm syndrome: can what we know about interleukin-6 in ovarian cancer be applied?

• Published in: Journal of ovarian research 2021-02, Vol.14 (1), p.28-16, Article 28
• Main Authors: Macciò, Antonio, Oppi, Sara, Madeddu, Clelia
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Analysis; Anemia; Aspirin - therapeutic use; B cells; Cancer; Care and treatment; Cell-mediated immunity; Coagulation; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - immunology; COVID-19 - metabolism; COVID-19 - mortality; COVID-19 - therapy; COVID-19 Drug Treatment; COVID-19 Serotherapy; COVID-19 Vaccines - pharmacology; Cytokine Release Syndrome - drug therapy; Cytokine Release Syndrome - etiology; Cytokine Release Syndrome - prevention & control; Cytokine storm; Development and progression; Disease; Disease spread; Fatalities; Female; Health aspects; Hemoglobin; Humans; Immune status; Immune system; Immunization, Passive; Immunopathology; Infections; Inflammation; Inflammation - drug therapy; Inflammation - virology; Interleukin 6; Interleukin-6 - immunology; Interleukin-6 - metabolism; Interleukins; Lymphocytes T; Medical prognosis; Necrosis; Oncology, Experimental; Ovarian cancer; Ovarian Neoplasms - complications; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - immunology; Ovarian Neoplasms - metabolism; Oxidative Stress; Pathogens; Patients; Prognosis; Resistance; Review; Severe acute respiratory syndrome coronavirus 2; T cells; Thrombosis; Tolerance; Tumor necrosis factor-TNF; Viral infections
• ISSN: 1757-2215; 1757-2215
• DOI: 10.1186/s13048-021-00772-6

Improving early diagnosis along with timely and effective treatment of COVID-19 are urgently needed. However, at present, the mechanisms underlying disease spread and development, defined prognosis, and immune status of patients with COVID-19 remain to be determined. Patients with severe disease state exhibit a hyperinflammatory response associated with cytokine storm syndrome, hypercoagulability, and depressed cell-mediated immunity. These clinical manifestations, sharing similar pathogenesis, have been well-studied in patients with advanced ovarian cancer. The present review suggests treatment approaches for COVID-19 based on strategies used against ovarian cancer, which shares similar immunopathology and associated coagulation disorders.The chronicization of the hyperinflammatory cytokine storm in patients with severe COVID-19 highlights a defective resistance phase that leads to aspecific chronic inflammation, associated with oxidative stress, which impairs specific T-cell response, induces tissue and endothelial damage, and thrombosis associated with systemic effects that lead to severe multi-organ failure and death. These events are similar to those observed in advanced ovarian cancer which share similar pathogenesis mediated primarily by Interleukin-6, which is, as well demonstrated in ovarian cancer, the key cytokine driving the immunopathology, related systemic symptoms, and patient prognosis.Consistent with findings in other disease models with similar immunopathology, such as advanced ovarian cancer, treatment of severe COVID-19 infection should target inflammation, oxidative stress, coagulation disorders, and immunodepression to improve patient outcome. Correctly identifying disease stages, based on available laboratory data, and developing a specific protocol for each phase is essential for effective treatment.