Beyond dexamethasone, emerging immuno‐thrombotic therapies for COVID‐19
Open accessAbstract
Host immunity is required to clear SARS‐CoV‐2, and inability to clear the virus because of host or pathogen factors renders those infected at risk of poor outcomes. Estimates of those who are able to clear the virus with asymptomatic or paucisymptomatic COVID‐19 remain unclear, and dependent on widespread testing. However, evidence is emerging that in severe cases, pathological mechanisms of hyperinflammation and coagulopathy ensue, the former supported by results from the RECOVERY trial demonstrating a reduction in mortality with dexamethasone in advanced COVID‐19. It remains unclear whether these pathogenic pathways are secondary to a failure to clear the virus because of maladaptive immune responses or if these are sequential COVID‐19 defining illnesses. Understanding the pathophysiological mechanisms underpinning these cascades is essential to formulating rationale therapeutic approaches beyond the use of dexamethasone. Here, we review the pathophysiology thought to underlie COVID‐19 with clinical correlates and the current therapeutic approaches being investigated.
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Treatment with corticosteroids has shown some efficacy against COVID-19.
“Treatment with corticosteroids, that act on multiple anti-inflammatory pathways (75), has shown some efficacy against COVID-19 (76).”
From Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19 (2021) · cites this paper as [76]
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Flagged first, then by citations
Research works printed but not linked: 3
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Cited by
Sorted by citations
D’Agnillo, F., Walters, K.-A., Xiao, Y., Sheng, Z.-M., Scherler, K., Park, J., Gygli, S., Rosas, L. A., Sadtler, K., Kalish, H., et al. (2021) · Science Translational Medicine · doi:10.1126/scitranslmed.abj7790 · Cited by 237 · see citing works
- Authors
- Jensen, M. P., George, M., Gilroy, D., & Sofat, R.
- Affiliations
- Royal London Hospital (GB)
- University College London (GB)
- Corresponding author
- Sofat, Reecha
- Venue
- British Journal of Clinical Pharmacology
- Publisher
- Wiley
- Published
- 2020-10-14
- Volume
- 87
- Issue
- 3
- Pages
- 845-857
- ISSN
- 0306-5251 (ISSN-L)
- 1365-2125
- OpenAlex
- W3082169420
- Cited by
- 17
- References
- 146
- Citations by year
- 2025: 1 · 2022: 11 · 2021: 4 · 2020: 1
- FWCI
- 0.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Clinical Pharmacology (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2020-21-012)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, SARS-CoV-2, dexamethasone, hyperinflammation, coagulopathy, host immunity, pathophysiology, severe COVID-19, anticoagulation, immunomodulatory therapy
- MeSH terms
- COVID-19, COVID-19 Drug Treatment, Antiviral Agents, Dexamethasone, Fibrinolytic Agents, Humans, Immunologic Factors, Randomized Controlled Trials as Topic
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