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Review
. 2021 Jan:45:100707.
doi: 10.1016/j.blre.2020.100707. Epub 2020 May 15.

Weathering the COVID-19 storm: Lessons from hematologic cytokine syndromes

James T England  1 , Alym Abdulla  1 , Catherine M Biggs  2 , Agnes Y Y Lee  1 , Kevin A Hay  1 , Ryan L Hoiland  3 , Cheryl L Wellington  4 , Mypinder Sekhon  5 , Shahin Jamal  6 , Kamran Shojania  6 , Luke Y C Chen  1   7
Affiliations
Review

Weathering the COVID-19 storm: Lessons from hematologic cytokine syndromes

James T England et al. Blood Rev. 2021 Jan.

Abstract

A subset of patients with severe COVID-19 develop profound inflammation and multi-organ dysfunction consistent with a "Cytokine Storm Syndrome" (CSS). In this review we compare the clinical features, diagnosis, and pathogenesis of COVID-CSS with other hematological CSS, namely secondary hemophagocytic lymphohistiocytosis (sHLH), idiopathic multicentric Castleman disease (iMCD), and CAR-T cell therapy associated Cytokine Release Syndrome (CRS). Novel therapeutics targeting cytokines or inhibiting cell signaling pathways have now become the mainstay of treatment in these CSS. We review the evidence for cytokine blockade and attenuation in these known CSS as well as the emerging literature and clinical trials pertaining to COVID-CSS. Established markers of inflammation as well as cytokine levels are compared and contrasted between these four entities in order to establish a foundation for future diagnostic criteria of COVID-CSS.

Keywords: COVID-19; Cytokine release syndrome; Cytokine storm syndrome; Hemophagocytic lymphohistiocytosis; Idiopathic multicentric Castleman disease; Severe acute respiratory syndrome coronavirus −2 (SARS-CoV-2).

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Conflict of interest statement

Kamran Shojania: Involved in investigator-initiated vasculitis study for Bristol-Myers-Squibb. Shahin Jamal: Attended Roche advisory board for tocilizumab in giant cell arteritis and rheumatoid arthritis. Kevin A. Hay: Attended Advisory boards and received honoraria for Celgene and Gilead related to CAR-T cell products. James T. England, Alym Abdulla, Ryan L. Hoiland, Cheryl L. Wellington, Mypinder Sekhon, Agnes Y.Y. Lee, Catherine Biggs, Luke Chen – no conflicts of interest to declare.

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