Emerging trends in COVID-19 treatment: learning from inflammatory conditions associated with cellular therapies

• Published in: Cytotherapy (Oxford, England) England), 2020-09, Vol.22 (9), p.474-481
• Main Authors: Cancio, Maria, Ciccocioppo, Rachele, Rocco, Patricia R.M., Levine, Bruce L., Bronte, Vincenzo, Bollard, Catherine M., Weiss, Daniel, Boelens, Jaap Jan, Hanley, Patrick J.
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; cellular therapy; Coronavirus Infections - drug therapy; Coronavirus Infections - etiology; Coronavirus Infections - physiopathology; COVID-19; CRS; cytokine release; Cytokine Release Syndrome - etiology; Cytokine Release Syndrome - therapy; HLH; Humans; hyperimmune response; Immune Reconstitution Inflammatory Syndrome - etiology; Immune Reconstitution Inflammatory Syndrome - therapy; Immunization, Passive; immunotherapy; Interleukin-1 - antagonists & inhibitors; Interleukin-6 - antagonists & inhibitors; IRIS; Killer Cells, Natural - immunology; Lymphohistiocytosis, Hemophagocytic - etiology; Lymphohistiocytosis, Hemophagocytic - therapy; Pandemics; Plasmapheresis; Pneumonia, Viral - etiology; Pneumonia, Viral - physiopathology; SARS-CoV-2; STAT Transcription Factors - antagonists & inhibitors
• ISSN: 1465-3249; 1477-2566
• DOI: 10.1016/j.jcyt.2020.04.100

Coronavirus disease 2019 (SARS-CoV2) is an active global health threat for which treatments are desperately being sought. Even though most people infected experience mild to moderate respiratory symptoms and recover with supportive care, certain vulnerable hosts develop severe clinical deterioration. While several drugs are currently being investigated in clinical trials, there are currently no approved treatments or vaccines for COVID-19 and hence there is an unmet need to explore additional therapeutic options. At least three inflammatory disorders or syndromes associated with immune dysfunction have been described in the context of cellular therapy. Specifically, Cytokine Release Syndrome (CRS), Immune Reconstitution Inflammatory Syndrome (IRIS), and Secondary Hemophagocytic Lymphohistiocytosis (sHLH) all have clinical and laboratory characteristics in common with COVID19 and associated therapies that could be worth testing in the context of clinical trials. Here we discuss these diseases, their management, and potential applications of these treatment in the context of COVID-19. We also discuss current cellular therapies that are being evaluated for the treatment of COVID-19 and/or its associated symptoms.