Department of Cardiovascular Disease Prevention, Department of Metabolic Disease Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Poland.
Eur Rev Med Pharmacol Sci. 2020 Dec;24(24):13062-13064. doi: 10.26355/eurrev_202012_24213.
Cytokine storm in COVID-19 is linked to disease severity and mortality. 40% of patients with severe COVID-19 require mechanical ventilation. Analgesia and sedation are used for treatment of pain, facilitation of mechanical ventilation, or management of acute agitation. Herein, we present the immunomodulating actions of morphine that may either improve or worsen the clinical course of COVID-19 once cytokine storm develops. A literature search was performed to find articles on potential immunomodulatory effects of morphine. Taken together, the results of in vitro and in vivo models in non-COVID-19 conditions suggest that morphine could have a beneficial effect by mitigating the cytokine storm in the early stages of severe COVID-19. In contrast, it could be potentially harmful in late stages of severe COVID-19, especially in the presence of septic shock.
COVID-19 中的细胞因子风暴与疾病严重程度和死亡率有关。40%的重症 COVID-19 患者需要机械通气。镇痛和镇静用于治疗疼痛、促进机械通气或管理急性激越。在此，我们介绍吗啡的免疫调节作用，一旦细胞因子风暴发展，吗啡可能会改善或恶化 COVID-19 的临床病程。进行了文献检索以查找有关吗啡潜在免疫调节作用的文章。总之，非 COVID-19 情况下的体外和体内模型的结果表明，吗啡在重症 COVID-19 的早期阶段通过减轻细胞因子风暴可能具有有益的作用。相比之下，它在重症 COVID-19 的晚期可能是有害的，尤其是在存在感染性休克的情况下。
