Cytokine storm, a fatal condition that lurks Covid patients

The impact of COVID-19 is indeed more severe for the elderly, especially those who have suffered from comorbidities such as diabetes, heart disease and lung disease. However, there have also been reports of deaths from COVID-19 in patients in their 20s or 30s. Scientists suspect that the cause of COVID-19's death has to do with a cytokine storm.

Cytokines are a part of the immune system. Cytokines are supposed to protect the body from infection. However, under the wrong conditions, the presence of cytokines can actually be life-threatening. What are cytokines and how do they relate to COVID-19? The following is a complete explanation.

The function of cytokines before a cytokine storm occurs in COVID-19 infection

Source: The Conversation

The immune system is made up of many components. There are white blood cells, antibodies, and so on. Each component works together to identify pathogens (germs), kill them, and form long-term defenses.

In order to carry out its functions, each component of the immune system must communicate with one another. This is where the role of cytokines comes in. Cytokines are special proteins that carry messages between 0 cells in the immune system.

Cytokines are divided based on the type of cells that produce them or how they work in the body. There are four types of cytokines, namely:

• Lymphokines, produced by T-lymphocytes. Its function is to direct the immune system's response to the area of ​​infection.
• Monokines, produced by monocyte cells. Its function is to direct neutrophil cells that will kill pathogens.
• Chemokines, produced by immune system cells. Its function is to trigger the transfer of the immune response to the area of ​​infection.
• Interleukins, produced by white blood cells. Its function is to regulate the production, growth, and movement of the immune response in inflammatory reactions.

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When SARS-CoV-2 enters the body, white blood cells respond by producing cytokines. The cytokines then travel to the infected tissue and bind to these cell receptors to trigger an inflammatory reaction.

Cytokines sometimes also bind to other white blood cells or work together with other cytokines when an infection occurs. The goal remains the same, namely to regulate the immune system to eradicate pathogens.

When there is inflammation, white blood cells will move to the infected blood or tissue to protect it from disease. In the case of COVID-19, cytokines move to the lung tissue to protect it from SARS-CoV-2 attacks.

Inflammation is actually useful for killing pathogens, but this reaction can also cause fever and other symptoms of COVID-19. After some time, the inflammation subsides and the body's immune system can fight the virus on its own.

Recognizing cytokine storms in COVID-19 patients

Many COVID-19 patients die because their immune systems are unable to fight off the infection. The virus also multiplies rapidly, causing multiple organs to fail at once, and ultimately resulting in death.

However, some doctors and scientists have found an unusual pattern in a number of COVID-19 patients. These patients experience mild symptoms, seem to be getting better, but after a few days, their condition drops dramatically to criticality or dies.

Dr. Pavan Bhatraju, ICU doctor at Harborview Medical Center Seattle, USA, mentioned this in his research. Decrease in the patient's condition generally occurs after seven days and is more prevalent in young, healthy COVID-19 patients.

They believe that the cause is the excessive production of cytokines. This is known as cytokine storm or cytokine storms. Instead of fighting infection, this condition can actually cause organ damage and be fatal.

Cytokines normally function briefly and stop when the body's immune response reaches the infection site. In cytokine storm conditions, cytokines continue to send signals so that immune cells keep arriving and reacting out of control.

The lungs become severely inflamed as the immune system tries its best to kill the virus. Inflammation can continue even after the infection is over. During inflammation, the immune system also releases molecules that are toxic to viruses and lung tissue.

The lung tissue was damaged. The patient's condition which was already good ended up deteriorating. Dr. Bhatraju said, patients who initially only need a little oxygen can experience respiratory failure overnight.

The effects of cytokine storms are drastic and rapid. Without proper treatment, the patient's lung function can decrease, making it difficult for the patient to breathe. On the other hand, the infection continues to get worse and results in organ failure.

Managing cytokine storms in COVID-19 patients

There are several types of drugs that can relieve cytokine storms in COVID-19 patients, one of which is known as interleukin-6. inhibitors (IL-6 inhibitors). These drugs work by blocking the action of cytokines that trigger inflammatory reactions.

Although it needs to be studied more deeply, reports from France and China indicate that IL-6 inhibitors has enough potential to quell a cytokine storm.

In one case, a patient who was close to being on a ventilator was able to breathe again a few hours after taking the drug.

Another patient who was given this drug was only briefly on a ventilator, even though he was supposed to be on a ventilator for several weeks. Right now, the task of scientists is to confirm that IL-6 inhibitors indeed effective against cytokine storms.

Meanwhile, the community can play an active role by making efforts to prevent COVID-19. Protect yourself by washing your hands and maintaining your immune system.

Also avoid interactions with other people to reduce the risk of spreading COVID-19 which can cause cytokine storms in some people.