What is Cytokine Storm and How it is Connected to COVID-19 Infection?

One of the most perplexing problems that most doctors around the world are worried about is how COVID can be mild in most people but deadly in others. Age and comorbidities certainly play a part, but doctors are seeing a wide variety of patients who shouldn't have had a serious reaction to COVID  become seriously ill and also die as a result of the viral infection. 

According to a new study, about 20 to 30 percent of COVID-19 patients admitted to hospitals have severe immune manifestations, which can lead to cytokine storms, which can result in life-threatening organ damage and death.

"If we can anticipate cytokine storm, we can apply treatment sooner and possibly decrease mortality," said Roberto Caricchio, MD, Chief of the Section of Rheumatology, Director of the Temple Lupus Program, Professor of Medicine and Microbiology and Immunology at LKSOM, and lead author of the new report. 

Cytokines are essentially proteins (glycoproteins) formed by various types of body cells. They support a variety of bodily functions, including immunity and inflammatory responses. However, if the body produces too much cytokine, things may go horribly wrong. It has the potential to cause a fatal reaction. Cytokine Storm is a condition in which the body produces so much cytokine. Read more

Scientists believe that during a cytokine storm, the body attacks its own cells and tissues rather than battling the virus. Many sick COVID-19 patients have high levels of immune system proteins called cytokines in their blood, according to reports. This typically occurs in the case of autoimmune disorders and in the course of certain cancer treatments. And, according to studies, the cytokine storm triggered by COVID is very strong.

It is well understood that once a virus infects a cell, it copies itself easily, causing a great deal of stress in a short period of time. When a cell detects something foreign, it kills itself to prevent the foreign entity from spreading to other cells. When a large number of cells do this at the same time, a huge portion of tissue can die, which can be harmful to the tiny air sacs in the lungs. They can cause pneumonia and even deplete oxygen levels in the blood, according to Mukesh Kumar, Virologist, and immunologist from Georgia State University, Atlanta. 

Dr. Kumar adds, "Basically, most of your cells will die because of the cytokine storm. It eats away at the lung. They cannot recover. It seems to play a role in death in a large number of cases."

This starts in the lungs but soon starts to affect other organs too. As the lungs are damaged by a Cytokine Storm, oxygen is unable to enter any part of the body, causing arteries to swell and raising the risk of a heart attack. Thrombosis, or blood clotting, is also can be fatal. 

Doctors prescribe certain drugs to keep the body from attacking itself when it senses a threat. This could save the lives of certain COVID patients. In the other hand, the use of these drugs is experimental, and there is no clear scientific evidence to support how they should be used. 

Research conducted by Temple Health University System "yielded six predictive criteria comprising three clusters of laboratory results relating to inflammation, cell death and tissue damage, and electrolyte imbalance. In particular, patients in cytokine storm exhibited a proinflammatory status and elevated levels of enzymes indicating significant systemic tissue damage. Moreover, patients who met the criteria had extended hospital stays and were at increased risk of death from COVID-19, with almost half of patients who experienced cytokine storm meeting all criteria within the first day of hospitalization."

According to some researchers, Cytokine Storm occurs in the second week after infection. As a consequence, the patient's diligence is much more important, and their condition must be closely monitored. However, some researchers believe that Cytokine Storm-related deaths in COVID patients are rare.

"Doctors begin to give anti-inflammatory drugs without much evidence which might not help the patients in recovering," says Philip Mudd, MD, Ph.D. 

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