A guide to immunotherapy for COVID-19
Publication date
2022-01
Authors
van de Veerdonk, Frank L.
Giamarellos-Bourboulis, Evangelos
Pickkers, Peter
Derde, Lennie P G
Leavis, Helen L
van Crevel, Reinout
Engel, Job J.
Wiersinga, W. Joost
Vlaar, Alexander P.J.
Shankar-Hari, Manu
Editors
Advisors
Supervisors
Document Type
Article
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taverne
Abstract
Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in clinical decision-making arise from the complexity of the disease phenotypes and patient heterogeneity, as well as the variable quality of evidence from immunotherapy studies. This Review aims to support clinical decision-making by providing an overview of the evidence generated by major clinical trials of host-directed therapy. We discuss patient stratification and propose an algorithm to guide the use of immunotherapy strategies in the clinic. This will not only help guide treatment decisions, but may also help to design future trials that investigate immunotherapy in other severe infections.
Keywords
Antibodies, Monoclonal/therapeutic use, Antibodies, Monoclonal, Humanized/therapeutic use, Antibodies, Neutralizing/therapeutic use, Anticoagulants/therapeutic use, Azetidines/therapeutic use, Bradykinin/analogs & derivatives, Bradykinin B2 Receptor Antagonists/therapeutic use, COVID-19/immunology, Complement Inactivating Agents/therapeutic use, Dexamethasone/therapeutic use, Drug Combinations, Factor Xa Inhibitors/therapeutic use, Glucocorticoids/therapeutic use, Heparin/therapeutic use, Humans, Hydrocortisone/therapeutic use, Imatinib Mesylate/therapeutic use, Immunization, Passive, Immunologic Factors/therapeutic use, Immunomodulation, Interferon beta-1a/therapeutic use, Interferon beta-1b/therapeutic use, Interferon-gamma/therapeutic use, Interleukin 1 Receptor Antagonist Protein/therapeutic use, Kallikrein-Kinin System, Piperidines/therapeutic use, Protein Kinase Inhibitors/therapeutic use, Purines/therapeutic use, Pyrazoles/therapeutic use, Pyrimidines/therapeutic use, SARS-CoV-2, Sulfonamides/therapeutic use, COVID-19 Serotherapy, Taverne, General Biochemistry,Genetics and Molecular Biology, Journal Article, Review
Citation
van de Veerdonk, F L, Giamarellos-Bourboulis, E, Pickkers, P, Derde, L, Leavis, H, van Crevel, R, Engel, J J, Wiersinga, W J, Vlaar, A P J, Shankar-Hari, M, van der Poll, T, Bonten, M, Angus, D C, van der Meer, J W M & Netea, M G 2022, 'A guide to immunotherapy for COVID-19', Nature Medicine, vol. 28, no. 1, pp. 39-50. https://doi.org/10.1038/s41591-021-01643-9