An inflammatory storm may result from pathogenic T cells and inflammatory monocytes with high levels of IL-6 secretion entering pulmonary circulation in large quantities. This occurrence can also cause an immune disorder in COVID-19 patients with severe complications.  

Smith College

- Cytokine Storm Syndrome
    -  Secondary Haemophagocytic Lymphohistiocytosis
- Common Variable Immunodeficiency 
- Figure illustrating how pathogenic T cells and inflammatory monocytes enter pulmonary circulation and incite an inflammatory storm and immune disorder 
- Severe Combined Immunodeficiency

Immunological Diseases as a Comorbidity of COVID-19

Fu, B., Xu, X., & Wei, H. (2020). Why tocilizumab could be an effective treatment for severe COVID-19?. Journal of translational medicine, 18(1), 1-5.

https://doi.org/10.1186/s12967-020-02339-3

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02339-3

Why tocilizumab could be an effective
treatment for severe COVID-19?

- A severe inflammatory response that presents as a fever, nausea, and swelling
- Has been observed in tandem with COVID-19 pulmonary symptoms
- Involves overproduction of cytokines (key proteins in the immune system)
- Immunosuppression can be helpful in calming the immune system and mitigating this extreme immune response

Secondary Haemophagocytic Lymphiohistocytosis and COVID-19

- Common Variable Immunodeficiency (CVID) is a disorder which lowers the immune systems defenses and makes patients more susceptible to infections in the lungs, sinuses, and ears
- A 53 y/o patient with CVID was admitted with COVID-19
- Patient was already receiving intravenous immunoglobulin (IVIG) for their CVID
- Levels of patient’s immunoglobulin were taken upon arrival and it was noted that their IgG was normal, but IgM and IgA were low and undetectable respectively
- Patient received additional IVIG daily as well as supplemental oxygen in the form of a nasal cannula and then intubation
- Patient was extubated after 3 days and eventually weaned back to room air as well as discharged on day 14 due to clinical improvement
- The paper also noted that there were 2 similar cases of CVID patients receiving supplemental IVIG in Italy who also made a similar recovery
- It was also stated that while testing was not performed for cytokine storm syndrome, 53 y/o did develop some acute respiratory distress syndrome during their treatment

Common Variable Immunodeficiency 

Figure illustrating how pathogenic T cells and inflammatory monocytes enter pulmonary circulation and incite an inflammatory storm and immune disorder 

- SARS-CoV-2 infection associated with hepatitis in an infant with X-linked severe combined immunodeficiency

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