Authors: Andreakos E, Papadaki M, Serhan CN

PMID: 32956495 PMCID: PMC7537007 DOI: 10.1111/all.14595


Coronavirus disease-19 (COVID-19) is a new disease caused by SARS-CoV-2. Since the beginning of 2020, it has become one of the main challenges of our times, causing a high incidence of severe pneumonia, acute respiratory distress syndrome (ARDS), multiorgan failure, and death. At the root of COVID-19 lies the sudden development of “cytokine storms,” hyperinflammatory responses involving the release of pro-inflammatory cytokines (eg, TNF, IL-6, IL-1, IL-8, and MCP-1) that impair the gas exchange function of the lung and lead in select patients, mostly with underlying comorbidities, to multiorgan failure, and death. Additional complications triggered by “cytokine storms” include endothelial dysfunction and hypercoagulation, increasing the risk of thromboembolytic events, and life-threatening cardiovascular complications. Anti-inflammatory therapies are thus being considered for alleviating the damaging side effects of hyperinflammation with many trials including anti-cytokine biologicals, disease-modifying antirheumatic drugs (DMARDs), and corticosteroids being ongoing. Surprisingly, among them dexamethasone has taken center stage as initial results from the RECOVERY trial, a large multicenter randomized open-label trial, for hospitalized patients run in the United Kingdom, revealed notable efficacy in the treatment of critically ill COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; dexamethasone; hyperinflammation; proresolving lipids.