Severe COVID-19, Another Piece in the Puzzle of the Hyperferritinemic Syndrome. An Immunomodulatory Perspective to Alleviate the Storm

Piero Ruscitti, Onorina Berardicurti, Paola Di Benedetto, Paola Cipriani, Annamaria Iagnocco, Yehuda Shoenfeld, Roberto Giacomelli

Research output: Contribution to journalReview articlepeer-review

Abstract

The coronavirus disease 2019 (COVID-19), an acute respiratory disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has been declared as a worldwide public health emergency. Interestingly, severe COVID-19 is characterized by fever, hyperferritinemia, and a hyper-inflammatory process with a massive release of pro-inflammatory cytokines, which may be responsible for the high rate of mortality. These findings may advocate for a similarity between severe COVID-19 and some challenging rheumatic diseases, such as adult onset Still's disease, secondary hemophagocytic lymphohistiocytosis, and catastrophic anti-phospholipid syndrome, which have been included in the “hyperferritinemic syndrome” category. Furthermore, as performed in these hyper-inflammatory states, severe COVID-19 may benefit from immunomodulatory therapies.

Original languageEnglish
Article number1130
JournalFrontiers in Immunology
Volume11
DOIs
StatePublished - 28 May 2020

Keywords

  • COVID-19
  • adult onset Still's disease
  • catastrophic anti-phospholipid syndrome
  • haemophagocytic lymphohistiocytosis
  • hyper-inflammation
  • hyperferritinaemic syndrome
  • hyperferritinemia

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