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cytokine storm syndrome

Posted , 11 users are following.

patricia43291
patricia43291

I've been reading about how a "cytokine storm", can be the final blow to patients of Covid-19 , and not the virus itself. And how doctors are- should, be testing all the patients who end up in the hospital, with a serum ferritin blood test, to check elevated values, for a possible storm. They have medications to calm the storm, ie, steroids, or other possible immune suppressant drugs. I found this interesting, because it is so related to our PMR, (the cytokines who are attacking our immune system).

Anybody else heard about this?

0 likes, 8 replies

8 Replies

  • EileenH
    EileenH patricia43291

    Posted

    They do find raised ferritin values in them but many of us have high ferritin levels as it, like ESR and CRP, is part of what is called the acute phase reaction. The thing that is most predictive of serious illness developing is patients having a high IL-6 level early in the disease process and it is thought that it may be the cytokine that triggers a cascade of other cytokines, up to 14 or so different ones, to be produced which turns into the "cytokine storm", as it is popularly known, and which results in overwhelming inflammation and fluid production in the lungs.

    IL-6 is one of the inflammatory substances implicated in PMR and GCA, there are others, and that is the substance that Actemra/tocilizumab targets in GCA. That is why they are trying out using it in patients with Covid 19. There is a small trial being carried out in Tuscany.

    • patricia43291
      patricia43291 EileenH

      Posted

      So why wouldn't they be testing for high IL-6 levels in every patient that enters the hospital, so they can give those patients a good dose of steriods, at least, or another drug like tocilizumab ?

    • Anhaga
      Anhaga patricia43291

      Posted

      Early on it was, apparently , discovered that medications like prednisone didn't help and in fact were harmful in this case. I don't know why, unless it's because with no immunity if a patient is ill enough to be on a ventilator then the idea is really to keep them alive long enough for their immune system to mount a defence - and this could be short circuited by a medication which at a not very high level actually dampens the immune response. So they need to find a safe medication which lowers inflammation without hobbling the immune system. Just guessing, though.

    • EileenH
      EileenH Anhaga

      Posted

      Not sure if that is the case with SARS-CO-2 - it was with the original SARS virus in 2003-ish.

    • EileenH
      EileenH patricia43291

      Posted

      IL-6 testing isn't available in all hospitals and it isn't increased right at the start I don't think, just earlier than the third stage of Covid-19. It isn't an easy test either - and you are looking at suddenly doing thousands of a test that you just aren't set up for routinely.

      As Anhaga says, there is some concern about using steroids - they just reduce the inflammation, they don't stop the cause which is possibly as important as the effect.

  • dan38655
    dan38655 patricia43291

    Posted

    This makes sense to me, since the body's response to perceived or actual infection often is the worst (perhaps even fatal) effect on the system.

    I look at it this way, the current methods of treating illness very often seem incredibly crude by the standards of the future, and the future always lies ahead.

    The trend seems to have always been toward better monitoring of the most relevant parameters, whether it's blood pressure or blood chemistry. The advancing field of proteomics and better in-body sensing instruments will perhaps allow continuous monitoring of myriad things such as cytokines or insulin, which is practically impossible at this time.

    Doctors, as well as athletes, will be using such technologies to help the body work as it should, and work better, respectively.

    A crisis such as this latest covid19 should promote research efforts into immunity that just may be useful in treating or preventing pmr.

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