In the innate immune response to SARS-CoV-2 infection, the host cells' pattern recognition receptors (PRR) recognise evolutionarily conserved molecular structures on the virus, called pathogen associated molecular patterns (PAMPS). When PAMPs bind to PRRs, the inflammatory response begins. PRRs activate several transcription factors to regulate the expression of genes responsible for inflammatory cytokine, interferon, chemokine, and adhesion molecule production.

Onset of Inflammatory Response in COVID-19

Michigan State University

Cytokines regulate acute and chronic inflammation in immune responses through a variety of complex pathways. They are produced by various immune cells (innate macrophages, dendritic cells, natural killer cells, adaptive T and B lymphocytes). 

Cytokines

Turner, M. D., Nedjai, B., Hurst, T., & Pennington, D. J. (2014). Cytokines and chemokines: at the crossroads of cell signalling and inflammatory disease. Biochimica et Biophysica Acta (BBA)-Molecular Cell Research, 1843(11), 2563-2582.
https://www.sciencedirect.com/science/article/pii/S0167488914001967
doi: 10.1016/j.bbamcr.2014.05.014

Cytokines and chemokines: At the crossroads of cell signalling and inflammatory disease

Cytokines in Adaptive Immunity

Cytokines in Anti-Inflammatory Signalling

- interleukins (IL)
- tumor necrosis factors (TNF)
- interferons (IFN)
- colony stimulating factors (CSF)

Cytokine Categorization

The term "cytokine storm syndromes (CSS)" encompasses many different inflammatory causes of disease (i.e., CSS represents various inflammatory etiologies). Regardless, the final results are shared: systematic inflammation, hemodynamic instability, multiple organ dysfunction, and potential death. Optimal treatment varies between different syndromes, making identification of the specific syndrome critical for effective treatment.

Cytokine storm syndromes are common in diseases such as systemic junvenile idiopathic arthrisits (JIA), adult onset Still’s disease, systemic lupus erythematosus, and many more. 

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