Cytokines are a varied group of proteins released by our immune system and play an essential role in normal immune responses. There are different cytokines, including chemokines, interferons, interleukins (IL), lymphokines, and tumor necrosis factor (TNF). The primary functions of cytokines include inflammatory response, angiogenesis, down and upregulation of receptors, and control of cell differentiation. 5 However, in response to a severe immune reaction, many cytokines are released into the bloodstream. This sudden increase in cytokines is known as a cytokine storm. 5 It can be severe or
IntroductIonAn estimated 48.9 million incident cases of sepsis were registered in 2017, with sepsis accounting for 19.7% of all global deaths. India contributed 11.3 million of these sepsis cases in 2017. Sepsis-related age-standardized incidence is 992/100,000 population. 1 The mortality rate with severe sepsis is about 30% in the Indian population. With low and mid-socioeconomic countries contributing to the doubling of sepsis globally in the last decade, a need for early diagnosis and treatment needs no emphasis. Newer insights into the pathophysiology of sepsis revolve around the imbalance in inflammatory mediators. 2 Cytokines act as mediators that are pivotal in the pathophysiology of sepsis. 3 Therapy to reduce, block, and filter cytokines continue to lure intensive care physicians around the globe. The present SARS-CoV-2 infection has generated interest for cytokine therapies in its management. 4
MaterIals a n d MethodsWe performed a literature review on the use of cytokine hemoadsorption therapies in Indian patients and looked at the clinical implications of such therapies in the current COVID-19 pandemic. An extensive literature search was done for keywords "hemoadsorption" and "CytoSorb®" using PubMed and Google Scholar search engines. All manuscripts with patients at Indian centers enrolled. We extend our review of cytokine storm in COVID-19 and the utility of CytoSorb® as an adjuvant in the management of septic shock in COVID-19.