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. 2021 Dec;101(Pt A):108328.
doi: 10.1016/j.intimp.2021.108328. Epub 2021 Nov 3.

COVID-19-Associated acute respiratory distress syndrome (CARDS): Mechanistic insights on therapeutic intervention and emerging trends

Komal Thapa  1 , Nitin Verma  2 , Thakur Gurjeet Singh  3 , Amarjot Kaur Grewal  4 , Neha Kanojia  2 , Lata Rani  2
Affiliations

COVID-19-Associated acute respiratory distress syndrome (CARDS): Mechanistic insights on therapeutic intervention and emerging trends

Komal Thapa et al. Int Immunopharmacol. 2021 Dec.

Abstract

Aims: The novel Coronavirus disease 2019 (COVID-19) has caused great distress worldwide. Acute respiratory distress syndrome (ARDS) is well familiar but when it happens as part of COVID-19 it has discrete features which are unmanageable. Numerous pharmacological treatments have been evaluated in clinical trials to control the clinical effects of CARDS, but there is no assurance of their effectiveness.

Materials and methods: A systematic review of the literature of the Medline, Scopus, Bentham, PubMed, and EMBASE (Elsevier) databases was examined to understand the novel therapeutic approaches used in COVID-19-Associated Acute Respiratory Distress Syndrome and their outcomes.

Key findings: Current therapeutic options may not be enough to manage COVID-19-associated ARDS complications in group of patients and therefore, the current review has discussed the pathophysiological mechanism of COVID-19-associated ARDS, potential pharmacological treatment and the emerging molecular drug targets.

Significance: The rationale of this review is to talk about the pathophysiology of CARDS, potential pharmacological treatment and the emerging molecular drug targets. Currently accessible treatment focuses on modulating immune responses, rendering antiviral effects, anti-thrombosis or anti-coagulant effects. It is expected that considerable number of studies conducting globally may help to discover effective therapies to decrease mortality and morbidity occurring due to CARDS. Attention should be also given on molecular drug targets that possibly will help to develop efficient cure for COVID-19-associated ARDS.

Keywords: COVID-19-associated ARDS (CARDS); Molecular drug targets; Pharmacological treatment; SARS-CoV-2 infection.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Mechanisms of SARS-CoV-2 associated cytokine storm and associated damages. Infection with SARS-CoV 2 stimulates hyperinflammatory immune response on release of DAMPS and PAMPS which further stimulates cytokine (IL-6 and TNF-α) and chemokine release from immune cells, wherein epithelial-cell-mediated production of reactive oxygen species (ROS) damages tissue of local and remote organs and impairs immune function which may lead to multiple organ failure. Further release of IFN-1 by plasmacytoid dendritic cells (pDC) in response to viral attack also impairs NK cell function.
Fig. 2
Fig. 2
Pathophysiology of COVID-19 induced ARDS.
Fig. 3
Fig. 3
Pharmacological Treatment Strategies for COVID-19associated ARDS.
See this image and copyright information in PMC

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