Iranian Red Crescent Medical Journal (IRCMJ)

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

Journal Metrics

News

Author Guidelines

Article Processing Charge

Chinese Medicine Treatment of Cytokine Storm Caused by COVID-19

Document Type : Review articles

Authors

1 Clinical Division, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China

2 Department of Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia

Abstract

Context: COVID-19 has turned into a pandemic, threatening the lives of millions of people worldwide. Research has found that some COVID-19 patients will suddenly aggravate, resulting in a cytokine storm, respiratory distress syndrome, and death. It is necessary to articulate the mechanism of cytokine storm and propose a Chinese medicine treatment strategy for COVID-19.
Evidence Acquisition: A literature search was conducted using five databases on April 30, 2020, including PubMed, Google Scholar, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data with the keywords of "cytokine storm AND Chinese medicine AND COVID-19 ", "cytokine storm AND Chinese medicine AND SARS-CoV-2". The outcome of interest was the concept and mechanism of cytokine storm, the characteristics, and the Chinese medicine treatment of COVID-19 cytokine storm, etc. A total of 43 articles were retrieved after removing duplicate articles.
Results: The cytokine storm is also called cytokine cascade. The body overreacts with positive feedback without negative feedback, making a variety of abnormal cytokines accumulations, triggering a cytokine storm. COVID-19 cytokine storm does not occur in the early stages, but only after a period of development, it attacks not only the lungs but also the heart, kidneys, and other organs. The key pathogenesis is "toxins and blood stasis, lung failure" in Chinese medicine. The treatment is detoxification, removing blood stasis, and nourishing the lung. Chinese medicine should comprehensively regulate multiple targets and multiple pathways to intervene in the immune regulation of the body to intercept the progress of inflammation and focus on the integration of Chinese medicine with Western medicine to combine anti-virus and anti-inflammatory therapy.
Conclusions: The immune response caused by cytokine storm is a complex signal network with multiple targets and pathways and various cytokines acting together. Immunomodulation can balance the excessive inflammatory response and effectively control the replication and spread of SARS-CoV-2. Returning the immune response to a balanced state is an ideal method for treating COVID- 19 cytokine storm. Chinese medicine can achieve overall coordination and balance. Nevertheless, the pharmacology of Chinese medicine must be further studied, and the mechanism of cytokine storm treatment should be thoroughly clarified

Keywords

References
  1. Mungroo MR, Khan NA, Siddiqui R. Novel coronavirus: Current understanding of clinical features, diagnosis, pathogenesis, and treatment options. Pathogens. 2020;9(4). doi: 10.3390/pathogens9040297. [PubMed: 32316618]. [PubMed Central: PMC7238102].
  2. Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-92. doi: 10.1038/s41579-018-0118-9. [PubMed: 30531947]. [PubMed Central: PMC7097006].
  3. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9. doi: 10.1038/s41586-020-2008-3. [PubMed: 32015508]. [PubMed Central: PMC7094943].
  4. Liu Y, Gayle AA, Wilder-Smith A, Rocklov J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2). doi: 10.1093/jtm/taaa021. [PubMed: 32052846]. [PubMed Central: PMC7074654].
  5. Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214-7. doi: 10.1016/j.ijid.2020.01.050. [PubMed: 32007643]. [PubMed Central: PMC7110798].
  6. Banerjee A, Baid K, Mossman K. Molecular pathogenesis of middle east respiratory syndrome (MERS) coronavirus. Curr Clin Microbiol Rep. 2019;6(3):139-47. doi: 10.1007/s40588-019-00122-7. [PubMed: 32226718]. [PubMed Central: PMC7100557].
  7. Chen J. Pathogenicity and transmissibility of 2019-nCoV-A quick overview and comparison with other emerging viruses. Microbes Infect. 2020;22(2):69-71. doi: 10.1016/j.micinf.2020.01.004. [PubMed: 32032682]. [PubMed Central: PMC7102641].
  8. Chen R, Liang W, Jiang M, Guan W, Zhan C, Wang T, et al. Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China. Chest. 2020;158(1):97-105. doi: 10.1016/j.chest.2020.04.010. [PubMed: 32304772]. [PubMed Central: PMC7158802].
  9. National Health Commission of the People's Republic of China. The novel coronavirus infected pneumonia diagnosis and treatment standards. Chinese; 2020.
  10. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. [PubMed: 31986264]. [PubMed Central: PMC7159299].
  11. Ye Q, Wang B, Mao J. The pathogenesis and treatment of the `Cytokine Storm' in COVID-19. J Infect. 2020;80(6):607-13. doi: 10.1016/j.jinf.2020.03.037. [PubMed: 32283152]. [PubMed Central: PMC7194613].
  12. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. doi: 10.1016/S0140-6736(20)30628-0. [PubMed: 32192578]. [PubMed Central: PMC7270045].
  13. Shi CS, Nabar NR, Huang NN, Kehrl JH. SARS-coronavirus open reading frame-8b triggers intracellular stress pathways and activates NLRP3 inflammasomes. Cell Death Discov. 2019;5:101. doi: 10.1038/s41420-019-0181-7. [PubMed: 31231549]. [PubMed Central: PMC6549181].
  14. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529-39. doi: 10.1007/s00281-017-0629-x. [PubMed: 28466096]. [PubMed Central: PMC7079893].
  15. Liu Q, Zhou YH, Yang ZQ. The cytokine storm of severe influenza and development of immunomodulatory therapy. Cell Mol Immunol. 2016;13(1):3-10. doi: 10.1038/cmi.2015.74. [PubMed: 26189369]. [PubMed Central: PMC4711683].
  16. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/s0140-6736(20)30211-7.
  17. Peiris JS, Lai ST, Poon LL, Guan Y, Yam LY, Lim W, et al. Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet. 2003;361(9366):1319-25. doi: 10.1016/s0140-6736(03)13077-2. [PubMed: 12711465]. [PubMed Central: PMC7112372].
  18. Cameron MJ, Bermejo-Martin JF, Danesh A, Muller MP, Kelvin DJ. Human immunopathogenesis of severe acute respiratory syndrome (SARS). Virus Res. 2008;133(1):13-9. doi: 10.1016/j.virusres.2007.02.014. [PubMed: 17374415]. [PubMed Central: PMC7114310].
  19. Okabayashi T, Kariwa H, Yokota S, Iki S, Indoh T, Yokosawa N, et al. Cytokine regulation in SARS coronavirus infection compared to other respiratory virus infections. J Med Virol. 2006;78(4):417-24. doi: 10.1002/jmv.20556. [PubMed: 16482545]. [PubMed Central: PMC7166776].
  20. Gralinski LE, Sheahan TP, Morrison TE, Menachery VD, Jensen K, Leist SR, et al. Complement activation contributes to severe acute respiratory syndrome coronavirus pathogenesis. mBio. 2018;9(5). doi: 10.1128/mBio.01753-18. [PubMed: 30301856]. [PubMed Central: PMC6178621].
  21. Gu M, Liu J, Shi NN, Li XD, Huang ZD, Wu JK, et al. [Analysis of property and efficacy of traditional Chinese medicine in staging revention and treatment of coronavirus disease 2019]. Zhongguo Zhong Yao Za Zhi. 2020;45(6):1253-8. Chinese. doi: 10.19540/j.cnki.cjcmm.20200225.501. [PubMed: 32281333].
  22. Zhang YS, Cong WH, Zhang JJ, Guo FF, Li HM. [Research progress of intervention of Chinese herbal medicine and its active components on human coronavirus]. Zhongguo Zhong Yao Za Zhi. 2020;45(6):1263-71. Chinese. doi: 10.19540/j.cnki.cjcmm.20200219.501. [PubMed: 32281335].
  23. Du HZ, Hou XY, Miao YH, Huang BS, Liu DH. Traditional Chinese medicine: An effective treatment for 2019 novel coronavirus pneumonia (NCP). Chin J Nat Med. 2020;18(3):206-10. doi: 10.1016/S1875-5364(20)30022-4. [PubMed: 32245590]. [PubMed Central: PMC7270732].
  24. Wang H, Jin XY, Pang B, Liu CX, Zheng WK, Yang FW, et al. [Analysis on clinical study protocols of traditional Chinese medicine for coronavirus disease 2019]. Zhongguo Zhong Yao Za Zhi. 2020;45(6):1232-41. Chinese. doi: 10.19540/j.cnki.cjcmm.20200220.501. [PubMed: 32281330].
  25. Liu R, Ge J, Zhong Y, Zheng Q, Sun R. Discussion on TCM treatment of severe novel coronavirus pneumonia based on the intervention of cytokine storm. Chin Tradit Herb Drugs. 2020;51(5):1096-105.
  26. Cheng D, Wang W, Li Y, Wu X, Zhou B, Song Q. Lianhua Qingwen efficacy analysis of 51 cases of COVID-19 patients: A multi-center retrospective study. Tianjin J Tradit Chin Med. 2020.
  27. Li H, Chang L, Wei C, Jia Z. Theoretical research and clinical efficacy of Lianhua Qingwen in the treatment of novel coronavirus pneumonia. World Chin Med. 2020;15(3):332-6.
  28. Shi X, Wei J, Liu M, Jin X, Zhou H, Zhu W, et al. Study on the overall regulation of Xuebijing injection in treating COVID-19. Shanghai J Tradit Chin Med. 2020;54(4):46-52.

Iranian Red Crescent Medical Journal (IRCMJ)
Volume 22, Issue 7 - Serial Number 7
2020
Files
History
  • Receive Date: 04 February 2021
  • Revise Date: 27 May 2024
  • Accept Date: 27 January 2024
  • First Publish Date: 27 January 2024
  • Publish Date: 01 July 2020
Share
How to cite
Statistics