What are cytokine storms and why are they responsible for so many deaths from Covid-19

COVID-19 is a disease that results from infection with the SARS-CoV-2 virus, a new coronavirus that is believed to have emerged in China in 2019 and that led to the pandemic we are currently experiencing. As explained by Dr Yvelise Barrios, member of the board of directors of the Spanish Society of Immunology (SEI), in an interview with Europa Press, this disease consists of two phases. A first where the virus plays a greater role, and a second where it is no longer so important to control it, but the exacerbation that takes place in the immune system after this infection and the first phase of the disease.

“In some patients the immune system is out of control and leads them to a serious situation from which they often cannot get out., having a poor prognosis, and many of them dying. However, since the start of the pandemic, we know a lot more about this disease and, in barely a year, we have taken giant steps to fight it ”, also recognizes the expert from the Universitario de Canarias hospital ( San Cristóbal de la Laguna, Tenerife), doctor specializing in immunology.

To be able to understand this cytokine storm that kills many people infected with COVIDDr. Barrios explains what cytokines are: “It is the information system that cells of the immune system have with other cells in the body. It is made up of the cells of the immune system which send substances to cells in other areas of our body, cytokines, responsible for giving the orders they deem relevant to any threat in our body“.

These cytokines, he continues, They have different functions (inhibiting, stimulating, for example), and some bind to receptors on other cells in the body, causing, for example, these cells to create other substances.

The doctor specializing in immunology emphasizes that it is a “messaging system” which normally acts appropriately in the event of any type of alarm. “This system generally stimulates or produces the messages necessary to defend ourselves and for us to continue with our healthy organism,” he emphasizes.

However, some infections or treatments say that they cause a disorder in this messaging system, the reasons for which are not always known to be accepted, and instead of producing and organizing cytokines in the right amounts, they get out of control and give alarm signals, and also continuously over time.

“With this, the immune response is disorganized, becoming exacerbated to such an extent that what it actually causes in the body is damage to the body. It is no longer the initial pathogen but this crazy system which does not recognize the immune response as adequate. It’s called ‘cytokine storm’, a term coined over 25 years ago, ”says the SEI board member.

Specific, the damage that the cytokine storm usually produces is directed to what are known as ‘target organs’, in the case of COVID the lungs and kidneys preferably, as well as damage to the vascular system, which end up causing the patient to have a series of very serious pathologies for which he can die.

Here it is important to note that in cytokine storms associated with COVID-19, there is a “series of alarms” that can be identified in some cases, whether the immune system is impaired or not, a series of biomarkers that can predict this poor prognosis, some of them related to coagulation.

For this reason, the member of the Spanish Society of Immunology indicates that there is a lot of research being done on treatments for COVID-19 aimed at controlling this hyperstimulation of the immune system, and that they have been tested throughout of this period, to see which ones are adequate. not in this first phase of the disease, but already in the second, when the immune system is out of control.

On the other hand, remember that cytokine storms can also occur with other diseases, not only with infection with SARS-CoV-2, although the one that occurs in COVID has very specific characteristics, such as leukopenia, which is not usual in other patients with this hyperstimulation.

Dr Barrios mentions that over 20 years ago the first descriptions of cytokine storms were recorded in a case of graft-versus-host disease, in the case of a transplant. This hyperstimulation of the immune system can also occur in CAR-T therapy, which is a very specific immunotherapy against certain hematologic neoplasms.

With information from Europa Press

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