The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China

• Published in: Clinical Immunology 2020-05, Vol.214, p.108393-108393, Article 108393
• Main Authors: Zhang, Wen, Zhao, Yan, Zhang, Fengchun, Wang, Qian, Li, Taisheng, Liu, Zhengyin, Wang, Jinglan, Qin, Yan, Zhang, Xuan, Yan, Xiaowei, Zeng, Xiaofeng, Zhang, Shuyang
• Format: Article
• Language: English
• Subjects: Anti-inflammation treatment; Anti-Inflammatory Agents - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Betacoronavirus; Chloroquine - therapeutic use; Coronavirus disease 2019 (COVID-19); Coronavirus Infections - drug therapy; COVID-19; Cytokine storm; Cytokines - immunology; Glucocorticoids - therapeutic use; Humans; Hydroxychloroquine - therapeutic use; Inflammation - pathology; Interleukin-6 - antagonists & inhibitors; Janus Kinases - antagonists & inhibitors; Pandemics; Pneumonia, Viral - drug therapy; Review; SARS-CoV-2; Thrombosis - virology; Vasculitis - virology
• ISSN: 1521-6616; 1521-7035
• DOI: 10.1016/j.clim.2020.108393

The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system. •The epidemic outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread all over the world.•Inflammatory cytokine storm was common in patients with severe COVID-19.•The immune system was impaired in critical COVID-19 patients•A timely anti-inflammation treatment at the right window time is of pivotal importance.