BLOCKADE OF THE CYTOKINE STORM IN SEVERE SARS-COV-2 INFECTION: DRUG SUPPRESSION OR EXTRACORPOREAL ELIMINATION?

Abstract

Background: The urgency of the treatment of severe COVID-19 is due to high mortality rate both in general patient population (6.4%) and in patients in intensive care units (25.8%). The cytokine storm is a pathological condition leading to high mortality. There are 2 approaches to reducing inflammatory cytokines in blood: blocking their production by drugs and extracorporeal removal. However, the choice is rather challenging.Purpose: A literature analysis was carried out to study modern approaches to prescribing medications and using extracorporeal detoxification for the blockade of the cytokine storm in severe COVID-19 patients.Material and methods: A total of 47 literature sources were analyzed.Results: The obtained information on modern methods of blocking the cytokine storm in severe COVID-19 infection indicates the effectiveness of both tocilizumab and selective anticytokine hemosorption as well as plasmapheresis and methods of renal replacement therapy.Conclusion: Based on our clinical observations, it was found out that not only drug suppression of inflammatory cytokines but also methods of extracorporeal blood purification can be effective in the treatment of severe COVID-19 pneumonia.