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When the immune system 'betrays' the body 5
A 43-year-old man went to a Paris hospital on March 17 with symptoms of fever and cough.
Two days later, his condition suddenly worsened and his oxygen levels decreased.
When the body is first exposed to a virus or bacteria, the immune system is activated, starting to `fight` the invading elements.
When the virus is inactivated, the immune system returns to its normal state.
`This happens to most patients,` said Dr. Randy Cron, an expert in Cytokine Release Syndrome at the University of Alabama, Birmingham, England.
An intensive care unit for Covid-19 patients in the city of Liège, Belgium.
But according to Mr. Cron, in some cases, in about 15% of people with infectious diseases, the immune system still works even after the virus is no longer active.
In these patients, it is the immune system, not the virus, that damages the body.
In the case of the 43 year-old patient in France, the ‘cytokine storm’ forced doctors to use tocilizumab, a drug that calms the activity of the immune system.
The case report was published in the medical journal Annals of Oncology, with research contributions from Italian and Chinese scientists.
On March 5, China approved this drug for serious cases.
The drug is used to inactivate a cytokine molecule called interleukin-6, which is involved in excessive immune response.
`This is the rationale for using this drug,` said Dr. Laurence Albiges of the Gustave Roussy Cancer Center in Paris.
Besides researching treatment methods, scientists also try to understand why some patients’ immune systems encounter this dangerous condition.
There are many variations of this phenomenon.
All are characterized by uncontrolled proliferation of immune molecules, which can lead to organ failure and death.
But many doctors are not familiar with this concept and do not know how to treat it.
Dr Jessica Manson, an immunologist at University College London Hospitals, said: `People talk about cytokine storm as a common phenomenon, but if you asked doctors just two weeks ago, they probably wouldn’t.
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Experts at a French laboratory are testing samples of suspected Covid-19 cases.
Patients with Cytokine Release Syndrome have an abnormally fast heart rate, fever, and hypotension.
A relatively simple and quick measure to detect whether people with Covid-19 are experiencing a cytokine storm or not, is the Ferritin test.
`If the immune response to infection compromises the patient, immediate treatment is needed,` Dr. Cron said.
But the reality is much more complicated, especially since the data for Covid-19 is limited.
`We need evidence-based data. But in a pandemic, we still have to treat the immediate patients,` he said.
Another drug effective in suppressing the cytokine storm is anakinra mutes interleukin-1.
Meanwhile, some doctors began turning to corticosteroids, which reduce the overall immune response.