The Role and Therapeutic Potential of NF-kappa-B Pathway in Severe COVID-19 Patients

Coronavirus disease 2019 (COVID-19) pandemic has affected health care systems worldwide. Severe presentations of COVID-19 such as severe pneumonia and acute respiratory distress syndrome (ARDS) have been associated with the post-viral activation and release of cytokine/chemokines which leads to a cytokine storm causing inflammatory response and destruction, mainly affecting the lungs. COVID-19 activation of transcription factor, NF-kappa B (NF-kappa B) in various cells such as macrophages of lung, liver, kidney, central nervous system, gastrointestinal system and cardiovascular system leads to production of IL-1, IL-2, IL-6, IL-12, TNF-alpha, LT-alpha, LT-beta, GM-CSF, and various chemokines. The sensitised NF-kappa B in elderly and in patients with metabolic syndrome makes this set of population susceptible to COVID-19 and their worse complications, including higher mortality. Immunomodulation at the level of NF-kappa B activation and inhibitors of NF-kappa B (I kappa B) degradation along with TNF-alpha inhibition will potentially result in a reduction in the cytokine storm and alleviate the severity of COVID-19. Inhibition of NF-kappa B pathway has a potential therapeutic role in alleviating the severe form of COVID-19.

Automated summary

COVID-19 causes a cytokine storm mainly affecting the lungs, with elderly and patients with metabolic syndrome being more susceptible. Immunomodulation targeting NF-kappa B activation and inhibitors can potentially reduce the cytokine storm, alleviating the severity of COVID-19. Inhibition of the NF-kappa B pathway may play a therapeutic role in alleviating severe forms of COVID-19.