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Understanding Cytokine Storm: What it is and how it may be responsible for Covid-19 related deaths

The phenomenon where the body releases too many Cytokine is known as a cytokine storm, it can trigger a severe inflammatory reaction which can be fatal

The second wave of the Covid-19 pandemic is much stronger compared to the first wave. India has been reporting the highest number of cases and causalities since April. Covid-19, unfortunately, harms the immunity of those who get infected, putting them at serious risk of getting other diseases that are comparatively rare in general. For example, the cases of black fungus or Mucormycosis are being reported in patients who have recovered from the deadly disease. Another condition that Covid-19 patients are developing is Cytokine Storm.

What is Cytokine Storm?

To understand what is Cytokine storm, first, it is essential to understand what Cytokine are. These are small glycoproteins that are produced by various types of cells in our bodies. When they are released, they promote a wide array of functions, including regulating immune and inflammatory responses. But, if the body releases far too much Cytokine, it can trigger a severe inflammatory reaction which can be fatal. The phenomenon where the body releases too many Cytokine is known as a cytokine storm.

Cytokine Storm can make immune system patient’s biggest enemy

A study done by Benedette Cuffari, M.Sc., claimed that Cytokine storm appears to play a direct role in determining the severity of SARS-CoV-2. She said, “One of the most notable clinical conditions that are associated with cytokine storms includes acute respiratory distress syndrome (ARDS), which has accounted for a significant number of deaths from SARS-CoV-2,” in her study.

Experts believe that if the Covid-19 patient gets severe Cytokine Storm and fails to get treatment in time, it can result in death. The deaths of Covid-19 patients due to multiple organ failure are believed to be caused by Cytokine Storm. Though the Cytokine are part of the Human immune response and help protect the body from various types of infection and diseases, in some Covid-19 patients, they are believed to begin to grow uncontrollably and attack the cells themselves, severely affecting the patient’s body. According to the experts, Covid-19 has the potential to make the patient’s own immune system his biggest enemy.

Cytokine storm may lead to multiple organ failure

According to a study done by Shintaro Hojyo et al., The cytokine storm in fatal COVID-19 is represented by several pathological features such as ARDS, coagulation, and multiorgan dysfunctions. Cytokine Storm can damage the lungs due to which oxygen does not reach every part of the body. It can swell up the arteries of the heart, increasing the risk of a heart attack. Also, there are chances of thrombosis or blood clotting, which can lead to sudden death. Experts believe that Cytokine Storm is more likely to happen in the second week after getting infected. Thus, the patient needs to be more cautious, and constant monitoring of the condition is necessary.

The oxygen levels fall dramatically during this Cytokine storm making it essential to shift the patient to ICU. Experts say that as Covid-19 is a comparatively new disease and a lot is still unknown about the infection, a comprehensive study is needed on the effects of Cytokine storm on the human body is necessary.

What happens in Cytokine Storm, and how is it treated?

In the case of Cytokine Storm, the body creates a substance known as Interleukin-6 (IL-6), which causes inflammation. The doctors prescribe anti-inflammatory drugs to control the effect and save the organs from any possible damage. In severe cases, the doctors may prescribe potent steroids as IL-6 blockers, but they must be taken only under the supervision of a specialist.

Counter studies questioning the role of Cytokine Storm in Covid-19 deaths

Several experts do not believe that Cytokine Storm is behind the increase in the number of deaths in Covid-19 cases. A study published in September 2020 by Matthijs Kox et al. stated that there was no direct link between Covid-19 and Cytokine Storm, as suggested.

Dr. Philip Mudd, MD, Ph.D., assistant professor of emergency medicine at Barnes-Jewish Hospital, said, “We found that cytokine storm does happen, but it’s relatively rare, even in the COVID-19 patients that go on to have respiratory failure and require a ventilator”. He added that the doctors started giving anti-inflammatory drugs without much evidence to the patients which might not help them in getting better.

According to the paper, when the researchers compared the levels of inflammatory Cytokine in Covid-19 patients with the group of patients suffering from other diseases, they did not find any evidence that suggests it was present in the Covid-19 patients. When they compared the Cytokine levels in severe Covid-19 patients who needed machine support, they did not found evidence of Cytokine Storm comparable to septic shock, which is the most common reason for Cytokine Storm.

Dr. Randy Cron, a professor of paediatrics and medicine at the University of Alabama at Birmingham, said that it is true that Covid-19 patients suffer from a higher level of Cytokine Storm, but they are not identical to the reactions caused by other disorders.

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