Working Paper Review Version 1 This version is not peer-reviewed

COVID-19 Perfect Storm (Part I): Cytokine Release Syndrome in Aged People

Version 1 : Received: 17 May 2020 / Approved: 18 May 2020 / Online: 18 May 2020 (12:46:48 CEST)

How to cite: Fiorino, S.; Gallo, C.; Zippi, M.; Sabbatani, S.; Manfredi, R.; Moretti, R.; Fogacci, E.; Maggioli, C.; Travasoni Loffredo, F.; Giampieri, E.; Corazza, I.; Dickmans, C.; Denitto, C.; Cammarosano, M.; Battilana, M.; Orlandi, P.E.; Del Forno, F.; Miceli, F.; Visani, M.; Acquaviva, G.; Leandri, P.; Jovine, E.; Jovine, R.; de Biase, D. COVID-19 Perfect Storm (Part I): Cytokine Release Syndrome in Aged People. Preprints 2020, 2020050303 Fiorino, S.; Gallo, C.; Zippi, M.; Sabbatani, S.; Manfredi, R.; Moretti, R.; Fogacci, E.; Maggioli, C.; Travasoni Loffredo, F.; Giampieri, E.; Corazza, I.; Dickmans, C.; Denitto, C.; Cammarosano, M.; Battilana, M.; Orlandi, P.E.; Del Forno, F.; Miceli, F.; Visani, M.; Acquaviva, G.; Leandri, P.; Jovine, E.; Jovine, R.; de Biase, D. COVID-19 Perfect Storm (Part I): Cytokine Release Syndrome in Aged People. Preprints 2020, 2020050303

Abstract

Objectives: In December 2019 a novel human-infecting coronavirus, SARS-CoV-2, has emerged. The WHO has stated the epidemic as a “public health emergency of international concern”. A drammatic situation has emerged with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a severe deficiency in nutrients as fatsoluble and hydrosoluble vitamins. Design: In this first part of the review about Cov2 in aged people, we searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We sed them as a paradigm with the purpose to retrieve pathogenetic mechanisms in common among these pathological conditions and SARS-CoV-2 infection, as well as the alteration induced in immune system function by this virus, or by its homologous SARS-CoV. Results: SARS-CoV-2 infection induces an important immune system dysfunction with the development of an exhuberant proinflammatory response in the host, and with the development of a life-threatening condition defined as Cytokine Release Syndrome (CRS). This leads to the Acute Respiratory Syndrome (ARDS), mainly in the aged people. High mortality and lethality rates have been observed in the elderly subjects with CoV-2-related infection. Conclusion: These diseases may serve as a paradigm for the study of CRS emerging in the course of SARS CoV-2 infection. This review discusses about the possible activity of Vitamin A, D, E and C in restoring normal antiviral Immune System function or the potential therapeutic role of these micronutrients as a part of a multi-treatment strategy against SARS- CoV-2 infection.

Subject Areas

SARS; CoV-2; COVID-19; immune system; cytokine

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