Journal
FRONTIERS IN PHARMACOLOGY
Volume 11, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2020.00870
Keywords
COVID-19; SARS-CoV-2; acute respiratory distress syndrome; neutrophils; neutrophilia; neutrophil extracellular traps; pathogenesis; therapeutics
Categories
Funding
- National Institute of General Medical Sciences of the National Institutes of Health (NIH) [P20GM103648]
- Oklahoma Center for the Advancement of Science & Technology (OCAST)
- Center for Veterinary Health Sciences, Oklahoma State University
- German Research Foundation (DFG) [CRC1181, FOR 2886]
- National University of Singapore
- Lupus Research Alliance of NY
- UTHSC
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There is an urgent need for new therapeutic strategies to contain the spread of the novel coronavirus disease 2019 (COVID-19) and to curtail its most severe complications. Severely ill patients experience pathologic manifestations of acute respiratory distress syndrome (ARDS), and clinical reports demonstrate striking neutrophilia, elevated levels of multiple cytokines, and an exaggerated inflammatory response in fatal COVID-19. Mechanical respirator devices are the most widely applied therapy for ARDS in COVID-19, yet mechanical ventilation achieves strikingly poor survival. Many patients, who recover, experience impaired cognition or physical disability. In this review, we argue the need to develop therapies aimed at inhibiting neutrophil recruitment, activation, degranulation, and neutrophil extracellular trap (NET) release. Moreover, we suggest that currently available pharmacologic approaches should be tested as treatments for ARDS in COVID-19. In our view, targeting host-mediated immunopathology holds promise to alleviate progressive pathologic complications of ARDS and reduce morbidities and mortalities in severely ill patients with COVID-19.
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