Historians and health professionals say that the “cytokine storm” was a common feature of the 1918 influenza. But how big of a potentially fatal immune response do coronavirus epidemics play?
About 500 million people, or a third of the world’s population, became infected with the Spanish flu in 1918. About 50 million people worldwide have died, with approximately 675,000 deaths in the U.S., according to the Centers for Disease Control and Prevention. As of Saturday, 57.6 million people worldwide contracted Covid-1 cont, killing 1.3 million people, 244,987 U.S. Were in
These scientists aimed to find out. According to research published Saturday by scientists from Memphis, Tenn., And Washington University School of St. Jude Children’s Research Hospital, most adults with moderate-to-severe COVID-19 have a more pronounced viral disease than those with influenza. Medicine in St. Louis, Mo.
“Less than 5% of patients with Covid-19 in this study had some survivors with a malignant, hyperinflammatory immune system known as cytokine storm syndrome. Cytokines are small proteins secreted by blood cells that help coordinate the immune response and stimulate inflammation.
“We identified a subset of Covid-19 patients with an extensively upgraded array of cytokines that are characteristic of cytokine storms,” said Paul Thomas, co-author of the Ph.D. . “But overall, the average person with Covid-1 – even in moderate to severe patients – has less inflammation than the average person with the flu.”
He said patients would benefit from a quick, reliable and inexpensive test to measure cytokines and identify those most likely with immunosuppressive therapy. Thomas added, “The findings suggest that anti-inflammatory treatment may be effective only in that minority of patients with a hyperinflammatory profile.”
Medical staff treat a patient with coronavirus at the COVID-19 Intensive Care Unit at United Memorial Medical Center on November 10, 2020 in Houston, Texas. Covid-19 infections are on the rise in Houston, Texas has surpassed 1 million cases.
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Characteristics of some viruses: The growth of immune cells and their activated compounds (known as “cytokines”) effectively turn the body against itself, leading to inflammation of the lungs, acute respiratory distress, causing the body to be susceptible to secondary bacterial pneumonia. It was seen as a reason why healthy people seem to be most affected by the 1918 flu.
The research included 168 adults with COVID-19, 26 adults with influenza and 16 healthy volunteers. More than 90% of the Civil-19 patients were hospitalized, about half in the intensive care unit; 23% of hospital admissions died. More than half of the flu patients were hospitalized, 35% died in the ICU and 8% of hospitalized flu patients died.
The study found that the antiviral-immune response in COVID-19 patients versus flu patients was “deeply suppressed”. In most cases, Covid-19 is not caused by widespread hyperinflammation from cytokines, but the lack of hyperinflammation in most coronavirus patients does not mean that they have less disease.
Doctors and members of the public, such as, yet, how strong, healthy people, who fell victim to the 1918 influenza, are also mistakenly referred to as the “Spanish flu”. Many historians today call it the “cytokine storm”, where the immune system in healthy people reacts as strongly as it harms the body.
According to Nature’s 2018 editorial, “there are two hypotheses to explain the high lethality of the 1918 strain: cytokine storm and secondary bacterial infections.” “In cytokine hurricanes, the body’s immune system is over-affected, causing tissue and organ damage, and even death.” However, the editorial says it is likely that there was a major role in the secondary bacterial infection.
The Natural Editorial cites an “interesting” 2008 paper published in the Journal of Infectious Diseases that examined and reviewed 8,400 tissue samples from 1918–1919 influenza deaths. Pneumonia is caused by bacteria from the common upper respiratory tract. “
This may correspond to the progression of the epidemic by hitting the second wave harder. “The second wave of the Spanish flu in 1918 was even more devastating than the first,” said Ravina Cooler, an infectious disease specialist at the Infectious Diseases Society of America and a faculty member at the University of California, Los Angeles.
Although the epidemic of 1918 has always been associated with Spain, the strain of H1N1 influenza actually occurred earlier in Germany, France, the UK and the US. Was found in, but similar to the Communist Party’s response to the first cases of COVID-19 in Wuhan, China, in December, buried World War I censorship or underplayed earlier reports.
Historian James Harris wrote: “The deep connection between the Great War and the influenza pandemic needs to be considered, not just as a simultaneous or persistent crisis, but as a more interconnected one. People became victims of the 1918 influenza. The “cytokine storm” seemed a possible explanation.
According to Nature’s 2018 editorial, “there are two hypotheses to explain the high lethality of the 1918 strain: cytokine storm and secondary bacterial infections.”
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The most recent study, released Saturday in the peer-reviewed open-journal Access Journal, Science Advances, published by the American Association for the Advancement of Science, suggests that most COVD-19 patients are not eligible for treatment with steroids such as dexamethasone. That, researchers argue, can backfire in some patients.
Dexamethasone, however, has been found to be effective in treating critically ill Covid-19 patients, according to three studies published in JAMA in September. Researchers reported in mid-June that low doses of dexamethasone played a key role in helping reduce the mortality of hospitalized COVID-19 patients by a third by ventilator.
According to other research, cytokine surges are at risk in older patients during the 2020 coronavirus epidemic. According to research published in the August issue of the Journal of Molecular and Cellular Cardiology, the body’s genes appear to be the main factor in allowing SARS-COV-access to heart cells.
Researchers have found that “inflammation can be more severe in the elderly, leading to organ damage,” the Johns Hopkins University report said. “Lung tissue becomes less elastic over time, with respiratory diseases such as Covid-19 a particular concern for the elderly.” Thus, it can promote cytokine storm inflammation and acute respiratory distress syndrome in patients.
Furthermore, a paper published in peer-reviewed Frontiers in the Journal of Immunology in September 2020 concluded: “Aberrant immune host response with cytokine storm and lymphocytopenia, [a disorder where your blood does not have enough white blood cells] Followed by acute respiratory distress, there are still related problems that affect the severity of COVID-19. “
The same thing exists between 1918 and 2020: During the 1918 flu, cities that applied non-pharmaceutical interventions such as social distance and school closures had better economic results, wrote Francis Yared, global head of rate research at the Deutsche Bank, recently. . Of note, he added, “there was not much trade between economic activity and public health.”
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