Open AccessThe Neutralizing Antibody Response against Severe Acute Respiratory Syndrome Coronavirus 2 and the Cytokine/Chemokine Release in Patients with Different Levels of Coronavirus Diseases 2019 Severity: Cytokine Storm Still Persists Despite Viral Disappearance in Critical Patients
Author(s) -
Lidya Handayani Tjan,
Tatsuya Nagano,
Koichi Furukawa,
Mitsuhiro Nishimura,
Jun Arii,
S Fujinaka,
Sachiyo Iwata,
Shigeru Sano,
Yoshiki Tohma,
Yoshihiro Nishimura,
Yasuko Mori
Publication year - 2021
Publication title -
jma journal
Language(s) - English
Resource type - Journals
eISSN - 2433-3298
pISSN - 2433-328X
DOI - 10.31662/jmaj.2020-0083
Subject(s) - cytokine storm , chemokine , immunology , virus , antibody , medicine , coronavirus , cytokine , cytokine release syndrome , virology , monoclonal antibody , neutralizing antibody , viral replication , disease , covid-19 , immune system , immunotherapy , infectious disease (medical specialty) , chimeric antigen receptor
Patients with coronavirus disease 2019 (COVID-19) exhibit a wide clinical spectrum ranging from mild respiratory symptoms to critical and fatal diseases, and older individuals are known to be more severely affected. The underlying mechanism of this phenomenon is unknown. A neutralizing antibody against viruses is known to be important to eliminate the virus. In addition, this antibody is induced at high levels in patients with severe COVID-19, followed by a termination of virus replication. Severe COVID-19 patients exhibit high levels of cytokines/chemokines, even after the disappearance of the virus. This indicates that cytokines/chemokines play significant roles in disease severity. These findings also suggest that antiviral therapy (monoclonal antibody and/or convalescent plasma therapy) should be administered early to eliminate the virus, followed by steroid treatment after viral genome disappearance, especially in patients with severe symptoms.