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Hyper-inflammatory responses in COVID-19 and anti-inflammatory therapeutic approaches

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The coronavirus disease 2019 (COVID-19) is an ongoing globalpandemic caused by severe acute respiratory syndrome coronavirus2 (SARS-CoV-2). Patients with severe COVID-19 exhibithyper-inflammatory responses characterized by excessive activationof myeloid cells, including monocytes, macrophages, andneutrophils, and a plethora of pro-inflammatory cytokines andchemokines. Accumulating evidence also indicates that hyperinflammationis a driving factor for severe progression of thedisease, which has prompted the development of anti-inflammatorytherapies for the treatment of patients with COVID-19. Corticosteroids, IL-6R inhibitors, and JAK inhibitors have demonstratedpromising results in treating patients with severe disease. In addition, diverse forms of exosomes that exert anti-inflammatoryfunctions have been tested experimentally for the treatmentof COVID-19. Here, we briefly describe the immunologicalmechanisms of the hyper-inflammatory responses in patientswith severe COVID-19. We also summarize current anti-inflammatorytherapies for the treatment of severe COVID-19 andnovel exosome-based therapeutics that are in experimental stages.

Abstract

The coronavirus disease 2019 (COVID-19) is an ongoing globalpandemic caused by severe acute respiratory syndrome coronavirus2 (SARS-CoV-2). Patients with severe COVID-19 exhibithyper-inflammatory responses characterized by excessive activationof myeloid cells, including monocytes, macrophages, andneutrophils, and a plethora of pro-inflammatory cytokines andchemokines. Accumulating evidence also indicates that hyperinflammationis a driving factor for severe progression of thedisease, which has prompted the development of anti-inflammatorytherapies for the treatment of patients with COVID-19. Corticosteroids, IL-6R inhibitors, and JAK inhibitors have demonstratedpromising results in treating patients with severe disease. In addition, diverse forms of exosomes that exert anti-inflammatoryfunctions have been tested experimentally for the treatmentof COVID-19. Here, we briefly describe the immunologicalmechanisms of the hyper-inflammatory responses in patientswith severe COVID-19. We also summarize current anti-inflammatorytherapies for the treatment of severe COVID-19 andnovel exosome-based therapeutics that are in experimental stages.

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