Flipped Inflammatory Time and the Role of Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2: Optimizing Tocilizumab Against Coronavirus Disease 2019.

Autor:	Guisado-Vasco P; Internal Medicine Department, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.; Universidad Europea, Madrid, Spain., Aguarles Gorines J; Research and Clinical Trials Unit, Hospital Universitario Quirónsalud Madrid, Madrid, Spain., Carralón González MM; Internal Medicine Department, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.; Universidad Europea, Madrid, Spain., Sotres Fernández G; Internal Medicine Department, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.; Universidad Europea, Madrid, Spain., Carnevali Ruiz D; Internal Medicine Department, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.; Universidad Europea, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2022 Aug 12; Vol. 226 (1), pp. 1-5.
DOI:	10.1093/infdis/jiac090
Abstrakt:	Use of interleukin (IL-6) inhibitors has become one of the most complicated clinical issues in treating coronavirus disease 2019 (COVID-19). Recently, randomized open-label platform trials have found that IL-6 inhibitors have a beneficial effect on mortality in severe COVID-19. However, several questions arise around their mechanism of action in this disease, as well as how, when, and at which dose they should be used. IL-6 has both proinflammatory and anti-inflammatory effects, which may modulate the course of COVID-19, whose immunopathogenesis is driven by the innate immune system, autoantibodies, and interferon. Given that patients with delayed seroconversion against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein would be at the highest risk of complications beyond the second week of disease, we propose that considering patient serostatus at admission could optimize the use of IL-6 inhibitors in COVID-19. We predict that the net treatment benefits could be higher in the subgroup of patients with delayed seroconversion as compared to those who seroconvert more rapidly after SARS-CoV-2 infection. Competing Interests: Potential conflicts of interest. P. G.-V. has received consultant fees from Angelini Pharma Spain and Pharma Mar, and speaking fees from GlaxoSmithKline (Spain) and Pharma Mar, outside the submitted work. All other authors report no potential conflicts of interest. (© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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