Immunomodulation as a Potent COVID-19 Pharmacotherapy: Past, Present and Future

Abstract

In the first year of its appearance, the 2019 coronavirus disease (COVID-19) has affected more than 120 million individuals and killed 2 million people worldwide. The pandemic has also triggered numerous global initiatives to tackle the newly emerging disease, including the development of SARS-CoV-2 vaccines and the attempt to discover potential pharmacological therapies. Nonetheless, despite the success of SARS-CoV-2 vaccines development, the COVID-19 therapy remains challenging. Several repurposed drugs that were documented to be useful in small clinical trials have been shown to be ineffective in larger studies. Additionally, the pathophysiology of SARS-CoV-2 infection displayed the predominance of cytokine storm in inducing multiorgan damage. Therefore, the potential benefits of both immune modulation and suppression in COVID-19 have been extensively discussed. Here, we reviewed the roles of immunomodulation as potential COVID-19 pharmacological modalities based on the existing data and proposed several new immunologic targets to be tested in the foreseeable future.

Molecular Mechanisms of Palmitic Acid Augmentation in COVID-19 Pathologies

“…The four molecules associated only with mild COVID-19 included cereblon (CRBN), hemoglobin (HBA)1/HBA2, JAK2, and tumor necrosis factor ligand superfamily member 11 (TNFSF11) (Table 1). Moreover, while only one chemokine/cytokine molecule was found to be associated with mild COVID-19, 15 chemokine/cytokine molecules were found to be associated with severe COVID-19 in QKB, which is consistent with the evidence of cytokine storm worsening the prognosis of COVID-19 [69], and the call for immunologic treatments in severe COVID-19 cases but not in mild COVID-19 cases [69]. It would be helpful to identify molecular profiles specific for mild and severe COVID-19, respectively, and use this molecular profile to facilitate the diagnosis and design of therapeutic interventions including immune modulation.…”

Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

“…Moreover, the choice of antiarrhythmics for patients who develop AF during infections is still an open debate, although some potentially relevant prognostic differences were outlined recently [ 71 , 72 ]. Ultimately, the role of immunomodulating therapies in this clinical scenario is still unclear and needs further specific investigation [ 73 ]. From a broader perspective, as AF occurring during COVID-19 may indicate increased clinical complexity, these patients should be carefully evaluated for the presence of other clinical conditions.…”

A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome—A Pilot Study

“…A significantly higher mean Vi PLUS value was found in COVID-19 patients with pulmonary injury (1.74 ± 0.28 vs. 1.64 ± 0.25, p < 0.0009) in our study. While inflammation plays a pivotal role in the development and progression of liver fibrosis, the non-invasive assessment of inflammation has been studied in past years, with promising results [ 32 , 33 , 34 , 35 , 36 , 37 ]. Several preliminary studies have shown that viscosity might be a useful parameter in tissue characterization, and it might help to detect necroinflammation in the liver [ 33 , 34 ].…”