Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Clin Immunol. 2021 Jan;222:108615. doi: 10.1016/j.clim.2020.108615. Epub 2020 Oct 23.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Wuhan, China has dispersed rapidly worldwide. Although most patients present with mild fever, cough with varying pulmonary shadows, a significant portion still develops severe respiratory dysfunction. And these severe cases are often associated with manifestations outside the respiratory tract. Currently, it is not difficult to find inflammatory cytokines upregulated in the blood of infected patients. However, some complications in addition to respiratory system with the coronavirus disease 2019 (COVID-19) are impossible to explain or cannot be attributed to virus itself. Thus excessive cytokines and their potentially fatal adverse effects are probably the answer to the multiple organ dysfunctions and growing mortality. This review provides a comprehensive overview of the mechanisms underlying cytokine storm, summarizes its pathophysiology and improves understanding of cytokine storm associated with coronavirus infections by comparing SARS-CoV-2 with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV).
新型冠状病毒病 2019（COVID-19）是由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的，该病毒最初于 2019 年 12 月在中国武汉被发现。这种新型冠状病毒迅速在全球范围内传播，给全球公共卫生带来了前所未有的挑战。尽管大多数患者表现为轻度发热、咳嗽伴不同程度的肺部阴影，但仍有相当一部分患者出现严重的呼吸功能障碍。这些严重病例常伴有呼吸道以外的表现。目前，在感染患者的血液中发现炎症细胞因子上调并不困难。然而，除了 COVID-19 之外，还有一些并发症是不可能解释的，或者不能归因于病毒本身。因此，细胞因子的过度释放及其潜在的致命不良反应可能是多器官功能障碍和死亡率上升的原因。本文全面综述了细胞因子风暴的发生机制，通过比较 SARS-CoV-2 与严重急性呼吸综合征冠状病毒（SARS-CoV）和中东呼吸综合征冠状病毒（MERS-CoV），总结了其病理生理学，并加深了对冠状病毒感染相关细胞因子风暴的认识。
