A guide to immunotherapy for COVID-19

被引：227

作者：

van de Veerdonk, Frank L. ^{[1
,2
]}

Giamarellos-Bourboulis, Evangelos ^{[3
]}

Pickkers, Peter ^{[4
,5
]}

Derde, Lennie ^{[6
]}

Leavis, Helen ^{[7
]}

van Crevel, Reinout ^{[1
,2
]}

Engel, Job J. ^{[1
,2
]}

Wiersinga, W. Joost ^{[8
]}

Vlaar, Alexander P. J. ^{[9
,10
]}

Shankar-Hari, Manu ^{[11
]}

van der Poll, Tom ^{[8
]}

Bonten, Marc ^{[12
]}

Angus, Derek C. ^{[13
,14
]}

van der Meer, Jos W. M. ^{[1
,2
]}

Netea, Mihai G. ^{[1
,2
,15
]}

机构：

[1] Radboud Univ Nijmegen, Med Ctr, Dept Internal Med, Nijmegen, Netherlands

[2] Radboud Univ Nijmegen, Med Ctr, Radboud Ctr Infect Dis, Nijmegen, Netherlands

[3] Univ Athens, Attikon Hosp, Dept Infect Dis, Athens, Greece

[4] Radboud Univ Nijmegen, Med Ctr, Dept Intens Care Med, Nijmegen, Netherlands

[5] Radboud Univ Nijmegen, Med Ctr, Radboud Ctr Infect Dis, Nijmegen, Netherlands

[6] Univ Med Ctr Utrecht, Dept Intens Care, Utrecht, Netherlands

[7] Univ Med Ctr Utrecht, Dept Internal Med, Utrecht, Netherlands

[8] Univ Amsterdam, Amsterdam UMC, Ctr Expt Mol Med CEMM, Div Infect Dis, Amsterdam, Netherlands

[9] Univ Amsterdam, Amsterdam UMC, Dept Intens Care Med, Amsterdam, Netherlands

[10] Univ Amsterdam, Amsterdam UMC, Lab Expt Intens Care Med & Anesthesiol, Amsterdam, Netherlands

[11] Kings Coll London, Sch Immunobiol & Microbial Sci, London, England

[12] Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[13] UPMC, Pittsburgh, PA USA

[14] Univ Pittsburgh, Pittsburgh, PA USA

[15] Univ Bonn, Life & Med Sci Inst, Dept Immunol & Metab, Bonn, Germany

来源：

NATURE MEDICINE | 2022年 / 28卷 / 01期

关键词：

KINASE INHIBITORS; TISSUE FACTOR; OPEN-LABEL; MULTICENTER; NEUTROPHILS; THROMBOSIS; IMMUNITY; C5A;

D O I：

10.1038/s41591-021-01643-9

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

This Review aims to support clinical decision-making by providing an overview of the evidence for immunotherapy strategies in patients with COVID-19. Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in clinical decision-making arise from the complexity of the disease phenotypes and patient heterogeneity, as well as the variable quality of evidence from immunotherapy studies. This Review aims to support clinical decision-making by providing an overview of the evidence generated by major clinical trials of host-directed therapy. We discuss patient stratification and propose an algorithm to guide the use of immunotherapy strategies in the clinic. This will not only help guide treatment decisions, but may also help to design future trials that investigate immunotherapy in other severe infections.

引用

页码：39 / 50

页数：12

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