Are superantigens the cause of cytokine storm and viral sepsis in severe COVID-19? Observations and hypothesis

Scand J Immunol. 2020 Dec;92(6):e12944. doi: 10.1111/sji.12944. Epub 2020 Aug 4.

Abstract

Right now the world is going through an unprecedented pandemic caused by a novel coronavirus. Recent papers pointed out the fatal outcome in most of the severe cases, in which a cytokine storm has been proven to be the cause of a systemic shock, acute respiratory syndrome, multiorgan failure and consequently death. Several explanations have been proposed trying to explain the pathophysiology of the cytokine storm, but viral proteins with a possible superantigen activity as a cause of immune dysregulation have not been addressed. If this hypothesis is proven, a different treatment approach might change the outcome in severe cases.

Keywords: COVID-19; cytokine storm; shock; superantigen.

MeSH terms

  • Antigen Presentation
  • CD4-Positive T-Lymphocytes / immunology*
  • COVID-19 / immunology*
  • Cytokines / metabolism
  • Dendritic Cells / immunology*
  • Humans
  • Pandemics
  • SARS-CoV-2 / physiology*
  • Sepsis / immunology*
  • Superantigens / immunology*

Substances

  • Cytokines
  • Superantigens