Abstract

HERNANDEZ-SOMERSON, Mario Andrés et al. Secondary hemophagocytic lymphohystiocytosis/cytokines release syndrome in SARS-CoV-2: a concise review. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.5, pp.263-268.  Epub May 23, 2022. ISSN 2448-8909.  https://doi.org/10.35366/102355.

There is increasing evidence of a dysregulation of the immune system associated with SARS-CoV-2 infection, which is directly related to COVID-19 severity and mortality. High levels of interleukins, especially IL-6, IL-1 and TNF alpha, decrease the anti-viral activity of interferon gamma and induce a decrease in the T lymphocyte count and a state of immune exhaustion that is associated with the clinical deterioration observed in these patients. This pathophysiological event has been called a cytokine storm and is common to other entities such as secondary hemophagocytic lymphohistiocytosis and macrophage activation syndrome seen in autoimmune diseases. There are no specific diagnostic criteria for this cytokine release syndrome associated with COVID-19. All these findings open the door to the use of immunodulatory treatment, especially therapy directed against cytokines, but clinical studies are required that clearly establish the risk-benefit ratio.

Keywords : COVID-19; cytokine storm; hemophagocytic lymphohystiocytosis; pneumonia; SARS-CoV-2.