3 Early in the pandemic, numerous studies reported an association between elevated inflammatory cytokine levels, particularly IL-6, and poor outcomes, including respiratory failure and death. Some risk factors for critical illness are older age, male gender, and co-morbid conditions, yet a substantial proportion of severe cases are driven by a maladaptive, pathological immune response known as COVID-19 cytokine storm (COVID-CSS) which can afflict young, otherwise healthy adults. 2 Surges of severe and critical patients have overwhelmed health care systems in many countries. The majority of those infected are asymptomatic or have mild ambulatory disease, but approximately 2%–10% develop severe disease leading to hospitalization and 25%–30% of hospitalized patients will require intensive care. In this commentary, we elaborate on their findings regarding the soluble interleukin (IL)-6 receptor and how further exploration of the complex checks and balances involved in IL-6 signaling may be key to diagnosing and treating COVID-19 immunopathology.ĬOVID-19 is associated with remarkably heterogeneous presentations and outcomes in humans. 1 Their cohort included patients with a broad spectrum of severities, including 12 critically ill, 20 ward, 1 discharged, and 52 ambulatory patients with a mix of acute and chronic phase samples. Koutsakos and colleagues provides a fresh perspective on the immune dysregulation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The comprehensive immunological study of 85 Australian patients with coronavirus disease of 2019 (COVID-19) by Dr.
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