Targeting the catecholamine-cytokine axis to prevent SARS-CoV-2 cytokine storm syndrome
Konig, M. F.; Powell, M.; Staedtke, V.; Bai, R.-Y.; Thomas, D. L.; Fischer, N.; Huq, S.; Khalafallah, A. M.; Koenecke, A.; Papadopoulos, N.; Kinzler, K. W.; Vogelstein, B.; Vogelstein, J. T.; Athey, S.; Zhou, S.; Bettegowda, C.
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In Coronavirus disease 2019 (COVID-19), the initial viral-replication phase is often followed by a hyperinflammatory reaction in the lungs and other organ systems that leads to acute respiratory distress syndrome (ARDS), the need for mechanical ventilation, and death despite maximal supportive care. As no antiviral treatments have yet proven effective, efforts to prevent progression to the severe stages of COVID-19 without inhibiting antiviral immune responses are desperately needed. We have previously demonstrated that a common, inexpensive, and well-tolerated class of drugs called alpha-1 adrenergic receptor (1-AR) antagonists can prevent hyperinflammation ("cytokine storm") and death in mice. We here present clinical data that supports the use of 1-AR antagonists in the prevention of severe complications of pneumonia, ARDS, and COVID-19.
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