Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review

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• dc.contributor.author Andaluz Ojeda, David
• dc.contributor.author Vidal Cortés, Pablo
• dc.contributor.author Aparisi, Álvaro
• dc.contributor.author Suberviola, Borja
• dc.contributor.author Del Río Carbajo, Lorena
• dc.contributor.author Nogales Martín, Leonor
• dc.contributor.author Prol Silva, Estefanía
• dc.contributor.author Nieto Del Olmo, Jorge
• dc.contributor.author Barberán, José
• dc.contributor.author Cusacovich, Ivan
• dc.date.accessioned 2023-02-17T07:05:03Z
• dc.date.available 2023-02-17T07:05:03Z
• dc.date.issued 2022
• dc.description.abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies. Aim: To describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of hyperinflammation and abnormal immune responses to disease progression together with a complete narrative review of the different immunoadjuvant treatments used so far in COVID-19 and their indication in severe and life-threatening subsets. Methods: A comprehensive literature search was developed. Authors reviewed the selected manuscripts following the PRISMA recommendations for systematic review and meta-analysis documents and selected the most appropriate. Finally, a recommendation of the use of each treatment was established based on the level of evidence of the articles and documents reviewed. This recommendation was made based on the consensus of all the authors. Results: A brief rationale on the SARS-CoV-2 pathogenesis, immune response, and inflammation was developed. The usefulness of 10 different families of treatments related to inflammation and immunopathogenesis of COVID-19 was reviewed and discussed. Finally, based on the level of scientific evidence, a recommendation was established for each of them. Conclusion: Although several promising therapies exist, only the use of corticosteroids and tocilizumab (or sarilumab in absence of this) have demonstrated evidence enough to recommend its use in critically ill patients with COVID-19. Endotypes including both, clinical and biological characteristics can constitute specific targets for better select certain therapies based on an individualized approach to treatment.
• dc.format.mimetype application/pdf
• dc.identifier.citation Andaluz-Ojeda D, Vidal-Cortes P, Aparisi Sanz Á, Suberviola B, Del Río Carbajo L, Nogales Martín L, Prol Silva E, Nieto Del Olmo J, Barberán J, Cusacovich I. Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review. World J Crit Care Med. 2022 Jul 9;11(4):269-97. DOI: 10.5492/wjccm.v11.i4.269
• dc.identifier.doi http://dx.doi.org/10.5492/wjccm.v11.i4.269
• dc.identifier.issn 2220-3141
• dc.identifier.uri http://hdl.handle.net/10230/55815
• dc.language.iso eng
• dc.publisher Baishideng Publishing Group
• dc.relation.ispartof World J Crit Care Med. 2022 Jul 9;11(4):269-97
• dc.rights © The Author(s) 2022. Published by Baishideng Publishing Group Inc. Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/Licenses/by-nc/4.0/
• dc.subject.keyword COVID-19
• dc.subject.keyword Critically ill patients
• dc.subject.keyword Immunomodulary drugs
• dc.subject.keyword Immunosupression
• dc.subject.keyword Phenotype
• dc.subject.keyword Treatment
• dc.title Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion