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Minerva Anestesiologica 2020 Aug 04

DOI: 10.23736/S0375-9393.20.14663-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Coronavirus disease 2019 (COVID-19) in critically ill patients: can we re-program the immune system? A primer for intensivists

Fiorenza FERRARI 1, 2 , Federico VISCONTI 1, Mara DE AMICI 3, Angelo GUGLIELMI 1, Costanza N. J. COLOMBO 1, Mirko BELLIATO 1, Claudio RONCO 2, 4

1 Department of Anesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy; 2 International Renal Research Institute of Vicenza (IRRIV) and Department of Nephrology, Dialysis and Transplantation, Vicenza, Italy; 3 Laboratory Immuno-Allergology of Clinical Chemistry Unit, Foundation IRCCS Policlinic San Matteo, Pavia, Italy; 4 Department Nephrology Dialysis & Transplant-AUSSL 8 regione Veneto, San Bortolo Hospital, Vicenza, Italy


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In December 2019, Coronavirus Disease 2019 (COVID-19) emerged in Wuhan and rapidly spread around the word. The immune response is essential to control and eliminate CoV infections, however, multiorgan damage might be due to direct SARS-CoV2 action against the infected organ cells, as well as an imbalanced host immune response. In effect, a “cytokines storm” and an impaired innate immunity were found in the COVID-19 critically ill patients. In this review, we summarize the virus immune response steps, underlying the relevance of introducing the measurement of plasma cytokine levels and of circulating lymphocyte subsets in clinical practice for the follow-up of critically ill COVID-19 patients and support new therapy.


KEY WORDS: COVID-19; Severe Acute Respiratory Syndrome; Cytokine storm; Immune
system response

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