A variety of therapies for COVID-19 are aimed at inhibiting the harmful consequences of a cytokine storm, defined as an exaggerated and out-of-control immune response. Cytokine storms assume that immune responses are often dysregulated and maladaptive, causing more harm than good. Several drugs are proposed to inhibit the cytokine storm in COVID-19, but will these drugs work?
This conversation was led by Joe Alcock, emergency physician and professor in the University of New Mexico Department of Emergency Medicine. He discussed the evidence for immunomodulatory drugs for infection and considered the concept of a cytokine storm in light of evolutionary medicine. Several evolutionary medicine concepts – the smoke detector principle, immune brinksmanship, mismatch, and cliff-edge effects may explain seemingly excessive immune responses. On the other hand, host-pathogen arms races may result in immune systems that are resistant to medical improvement.