key: cord-0855184-b30nkhcs
authors: Chakraborty, Chiranjib; Sharma, Ashish Ranjan; Bhattacharya, Manojit; Sharma, Garima; Lee, Sang‐Soo; Agoramoorthy, Govindasamy
title: COVID‐19: Consider IL6 receptor antagonist for the therapy of cytokine storm syndrome in SARS‐CoV‐2 infected patients
date: 2020-05-28
journal: J Med Virol
DOI: 10.1002/jmv.26078
sha: bd8f26d1794d714d1fc696788609cb08109f6db2
doc_id: 855184
cord_uid: b30nkhcs

COVID‐19 leads to mortality of several patients and the cytokine storm is reportedly critical in the patients. In order to reduce the cytokine storm, we would like to propose the IL6 receptor antagonist therapy for the COVID‐19 patients. Two humanized monoclonal antibodies are in clinical trial following IL6R antagonist therapies namely tocilizumab and sarilumab. However, researchers and physicians should look for more IL6 receptor antagonists for the therapy of cytokine storm syndrome SARS‐CoV‐2 infected persons to enhance the therapeutic options for cytokine storm. This article is protected by copyright. All rights reserved.

Tocilizumab can be used to treat cytokine storm of the COVID-19 patients that targets IL-6R 9 . It is a humanized monoclonal antibody (hmAB) and also is an antagonist IL-6R. IL-6 level is significantly increased in serum in COVID-19 infected severe patients. IL-6 is a one of the major cytokines, which can create inflammatory storm. This may consequence of impair oxygen diffusion. Due to this, respiratory muscles become fatigued and that may finally leads to respiratory failure. In this case, Tocilizumab may be the right therapeutic choice to treat critical patients.

A clinical trial study in China found hmAB to be a useful treatment of severely affected COVID-19 patients with augmented IL-6 levels. In this study, the initial dose was used as This article is protected by copyright. All rights reserved. 

Similarly, Sarilumab can also be applied for the therapeutic purpose of cytokine storm of the COVID-19 patients. It is also a humanized monoclonal antibody and also is an antagonist IL-6R. Clinical trials of Sarilumab have been initiated for the therapy of the cytokine storm syndrome in SARS-CoV-2 infected victims 13,14 .

Therapeutic molecules with the IL6 receptor antagonist property can be applied for the cure of the cytokine storm syndrome in SARS-CoV-2 infected patients. IL6R antagonist may be one of the best choices to treat severe COVID-19 patients. However, there are some open questions needs to be answered: what is the molecular mechanism of these

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