Hyperinflammation and the utility of immunomodulatory medications in children with COVID-19

Tamara Tanner; Dawn M Wahezi

doi:10.1016/j.prrv.2020.07.003

Hyperinflammation and the utility of immunomodulatory medications in children with COVID-19

Paediatr Respir Rev. 2020 Sep:35:81-87. doi: 10.1016/j.prrv.2020.07.003. Epub 2020 Jul 29.

Authors

Tamara Tanner¹, Dawn M Wahezi²

Affiliations

¹ Division of Pediatric Rheumatology, Children's Hospital at Montefiore, 3415 Bainbridge Ave, Bronx, NY, 10467, United States. Electronic address: [email protected].
² Division of Pediatric Rheumatology, Children's Hospital at Montefiore, 3415 Bainbridge Ave, Bronx, NY, 10467, United States. Electronic address: [email protected].

Abstract

The rapid spread of SARS-CoV-2 infection globally coupled with the relatively high case-fatality rate has led to immediate need for therapeutic intervention to prevent and treat COVID-19 disease. There is accumulating evidence that morbidity and mortality in COVID-19 may be exacerbated by a dysregulated host immune response resulting in significant hyperinflammation and cytokine release. The aim of this review is to describe the basis for the immune dysregulation caused by SARS-CoV-2 infection and to examine current investigations into immunomodulatory therapies aimed at targeting the excessive host immune response.

Keywords: Children; Immune dysregulation; Multi-system inflammatory syndrome [MIS-C]; SARS-CoV-2; Treatment.

Publication types

Review

MeSH terms

Adrenal Cortex Hormones / therapeutic use
Antibodies, Monoclonal, Humanized / therapeutic use
Antigen-Antibody Complex / immunology
Betacoronavirus
COVID-19
COVID-19 Drug Treatment
COVID-19 Serotherapy
Child
Coronavirus Infections / drug therapy
Coronavirus Infections / immunology*
Coronavirus Infections / physiopathology
Coronavirus Infections / therapy
Cytokine Release Syndrome / immunology*
Cytokine Release Syndrome / physiopathology
Cytokine Release Syndrome / therapy
Humans
Immunization, Passive / methods
Immunoglobulins, Intravenous / therapeutic use
Immunologic Factors / therapeutic use*
Inflammation / immunology
Inflammation / physiopathology
Inflammation / therapy
Interleukin 1 Receptor Antagonist Protein / therapeutic use
Janus Kinase Inhibitors / therapeutic use
Pandemics
Pneumonia, Viral / immunology*
Pneumonia, Viral / physiopathology
Pneumonia, Viral / therapy
Receptors, Interleukin-6 / antagonists & inhibitors
SARS-CoV-2
Systemic Inflammatory Response Syndrome / immunology*
Systemic Inflammatory Response Syndrome / physiopathology
Systemic Inflammatory Response Syndrome / therapy

Substances

Adrenal Cortex Hormones
Antibodies, Monoclonal, Humanized
Antigen-Antibody Complex
Immunoglobulins, Intravenous
Immunologic Factors
Interleukin 1 Receptor Antagonist Protein
Janus Kinase Inhibitors
Receptors, Interleukin-6
tocilizumab
sarilumab

Supplementary concepts

pediatric multisystem inflammatory disease, COVID-19 related