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Coronavirus Outbreak Explained: What Is A Cytokine Storm And How Is It Fuelling COVID-19? Experts Answer

According to experts, a portion of the infected patients develop severe COVID-19 because of an overreaction of their immune systems, which triggers a syndrome called a cytokine storm

Coronavirus Outbreak Explained: What Is A Cytokine Storm And How Is It Fuelling COVID-19? Experts Answer
Highlights
  • Cytokines are proteins released by immune system in response to infection
  • Cytokine storm is a hyper reaction of the immune system and kills good cell
  • Cytokine storm can cause multiple organ failures

New Delhi: As scientists and the medical community across the world are struggling to tackle the COVID-19 pandemic, they are continuously learning something new about it. One of the mysteries of the novel coronavirus- SARS-CoV-2, according to experts, is that it causes only mild to moderate symptoms in most people but turns out to be fatal for others causing multiple organ failure and even death. The answer to this mystery, according to experts, could lie in the emerging evidence that in many cases, severe COVID-19 may be driven by an overreaction of their immune systems against the infection where the body starts to attack its own cells and tissues, rather than the virus itself. This abnormal immune response to the infection is called ‘cytokine storm’, which experts say, is one of the fuelling agents of COVID-19.

Also Read: Coronavirus Outbreak Explained: What Is A Pulse Oximeter And Why Is It Becoming A Tool Against COVID-19?

What Are Cytokines And Cytokines Storms?

According to Dr Raman Dhara, Additional Professor, Indian Institute of Public Health (IIPH), Hyderabad, cytokines are small soluble molecules or proteins released by the immune system in response to an infection that act as messengers for the immune system. As they attract immune cells to counter the infection, which can be of any kind, cytokines trigger inflammation, he said.

Dr Aviral Roy, Consultant Critical Care, Medica Superspecialty Hospital explained the cytokines by comparing the immune system fighting infections in the body to an army of soldiers combating infiltrators. He said,

Suppose, a terrorist infiltrates in a country. For the first 3-4 day, nobody gets to know about it. Then one of the soldiers picks it up and tell his team that there’s some suspicious activity going on. He communicates this to everybody else including the commanding authorities and asks about what needs to be done with the infiltrator. This communication system in your body is called cytokine. It takes the message from one cell to another about where the virus is in the body and how to attack it. So cytokine is your immune system’s signalling agent.

He further said that the cytokine storm is when the immune system loses the ability to identify the good cells from virus affected or bad cells. He said,

In cytokine storm, the immune system which is originally attacking the virus, now, goes into hyperdrive and basically starts destroying all cells.

Cytokine storm is when a hyperimmune reaction occurs and abnormally high quantity of cytokine proteins are released into the blood too quickly, explained Dr Dhara. He added,

In simpler words, Immune response is more than it should be!

While normally cytokines regulate immune responses, in hyper reaction case they cause harm and can even cause death.

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The Role Of Cytokines Storms In Severe COVID-19

Experts said that cytokine storms have been observed in several individuals who are critical with COVID infection. A study named ‘COVID-19: Pathogenesis, cytokine storm and therapeutic potential of interferons’ published in Elsevier Public Health Emergency Collection, accessible in PubMed Central (PMC) repository of the National Institute of Health (NIH), USA, says that acute respiratory distress syndrome (ARDS) is the main cause of death in COVID-19 disease. It further states that one of the main features of ARDS is the cytokine storm – an uncontrolled systemic inflammatory response resulting from the release of pro-inflammatory cytokines by immune activated cells. As per the study, high blood levels of cytokines have been detected in patients with COVID-19 infection.

High cytokines flow suppresses oxygen utilisation in the body and cause hypoxia- the state of insufficient oxygen as it kills cells, which leads to multiple organ failure like kidney failure, heart failure and even impacts the functioning of the brain. Dr Roy said,

In a COVID-19 patient, cytokine storm starts in lungs, which is why the lungs get affected initially, then as the storm loses control and starts attacking other organs which lead to multi-organ failure. As oxygen starts decreasing in the body, it starts working inefficiently including the immune system.

Also Read: Coronavirus Outbreak Explained: What Is Herd Immunity And Can It Control The Coronavirus Pandemic?

Can Preventing Cytokine Storm Ease Severe COVID-19 Symptoms?

“Cytokine storms are called storms because they are unpredictable and uncontrollable”, said Dr Roy adding that preventing cytokine storm is not possible and it can be only modulated to some extent with help of immunomodulation medicines. He said,

There is no way to prevent the cytokine storm. It is not possible to stop cytokine from working because, in the absence of cytokine, the virus itself will the patient. The storm can only be modulated via immunomodulators that can keep the immune system active and at the same time not attacking all cells.

Dr Dhara added that modulating the cytokine storm can dampen the hyper inflammation and lessen the collateral damage caused by the runaway reaction. He said,

Various drugs such as anti-tumour necrosis factor, cyclooxygenase inhibitors, are potential cytokine storm inhibitors. Some of them are currently in clinical trials for COVID-19.

According to experts, cytokine storms are not unique to COVID-19 infection and happen in patients with any kind of severe infection like bird flu caused by H5N1 influenza virus, Middle East respiratory syndrome coronavirus caused by MERS-CoV, and others.

Also Read: Coronavirus Explained: What Is Middle East Respiratory Syndrome Coronavirus?

World

26,58,63,058Cases
22,65,37,591Active
3,40,69,608Recovered
52,55,859Deaths
Coronavirus has spread to 196 countries. The total confirmed cases worldwide are 26,58,63,058 and 52,55,859 have died; 22,65,37,591 are active cases and 3,40,69,608 have recovered as on December 6, 2021 at 5:12 am.

India

3,46,41,561 8,306Cases
98,416739Active
3,40,69,608 8,834Recovered
4,73,537 211Deaths
In India, there are 3,46,41,561 confirmed cases including 4,73,537 deaths. The number of active cases is 98,416 and 3,40,69,608 have recovered as on December 6, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

66,38,778 707

10,826 23

64,86,782 677

1,41,170 7

Kerala

51,65,921 4,450

44,110 317

50,80,211 4,606

41,600 161

Karnataka

29,98,099 456

7,161 120

29,52,708 330

38,230 6

Tamil Nadu

27,30,516 724

8,041 29

26,85,946 743

36,529 10

Andhra Pradesh

20,73,730 154

2,122 27

20,57,156 177

14,452 4

Uttar Pradesh

17,10,475 24

134 18

16,87,430 6

22,911

West Bengal

16,19,257 620

7,639 17

15,92,074 627

19,544 10

Delhi

14,41,358 63

370 48

14,15,890 15

25,098

Odisha

10,50,249 189

2,154 25

10,39,673 212

8,422 2

Chhattisgarh

10,06,967 25

330 4

9,93,044 21

13,593

Rajasthan

9,54,891 17

221 8

9,45,715 9

8,955

Gujarat

8,27,707 48

349 23

8,17,263 24

10,095 1

Madhya Pradesh

7,93,241 9

133 9

7,82,580 18

10,528

Haryana

7,71,819 22

185 5

7,61,580 17

10,054

Bihar

7,26,237 6

26 4

7,14,121 2

12,090

Telangana

6,76,943 156

3,787 8

6,69,157 147

3,999 1

Assam

6,17,576 101

2,490 61

6,08,966 158

6,120 4

Punjab

6,03,488 37

361 14

5,86,519 23

16,608

Jharkhand

3,49,342 25

127 12

3,44,074 13

5,141

Uttarakhand

3,44,353 8

174 1

3,36,768 7

7,411

Jammu And Kashmir

3,37,807 161

1,706 25

3,31,620 184

4,481 2

Himachal Pradesh

2,27,518 35

755 45

2,22,911 80

3,852

Goa

1,79,174 49

412 18

1,75,375 31

3,387

Mizoram

1,36,454 92

3,101 454

1,32,846 544

507 2

Puducherry

1,29,085 29

280 14

1,26,930 43

1,875

Manipur

1,25,360 32

353 9

1,23,025 40

1,982 1

Tripura

84,858 5

90 1

83,943 6

825

Meghalaya

84,583 9

244 2

82,864 11

1,475

Chandigarh

65,488 7

58 2

64,610 9

820

Arunachal Pradesh

55,293 5

36 4

54,977 1

280

Sikkim

32,369 10

215 2

31,749 8

405

Nagaland

32,136

117 9

31,320 9

699

Ladakh

21,714 31

295 3

21,204 34

215

Dadra And Nagar Haveli

10,683

0 0

10,679

4

Lakshadweep

10,404

10 0

10,343

51

Andaman And Nicobar Islands

7,688

4 2

7,555 2

129

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1 Comment

1 Comment

  1. Jyoti bjuskan

    August 21, 2020 at 4:27 pm

    Excellent information

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