Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 25 , ISSUE 4 ( April, 2021 ) > List of Articles

CASE REPORT

Multiple Peaked Cytokine Storm: Is Multiple Exposures to the COVID-19 Virus a Possible Cause?

Amarjeet Kumar, Abhyuday Kumar, Ajeet Kumar, Neeraj Kumar, Chandni Sinha, Veena Singh

Keywords : COVID-19, Cytokine storm, Interleukin-6,Acute respiratory distress syndrome

Citation Information : Kumar A, Kumar A, Kumar A, Kumar N, Sinha C, Singh V. Multiple Peaked Cytokine Storm: Is Multiple Exposures to the COVID-19 Virus a Possible Cause?. Indian J Crit Care Med 2021; 25 (4):463-464.

DOI: 10.5005/jp-journals-10071-23786

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Severe acute respiratory syndrome coronavirus 2 is the pathogen that causes coronavirus disease 2019 (COVID-19). Recent studies have shown that the “cytokine storm” (high concentration of proinflammatory cytokines) may contribute to the mortality of COVID-19. Repeated exposure to the virus can lead to a dose-dependent immune response that may be associated with more disease severity and higher mortality. Sudden deterioration/increased oxygen consumption after initial improvement may be due to multiple surges of cytokines storm within a short period, the possible cause may be due to multiple exposures within the incubation period. We hypothesize that multiple surges in cytokines storm in some patients may be due to multiple exposures of the same patient within the incubation period, sepsis, or other inflammatory lesions inside the body. In our cases, sepsis as a cause of cytokine storm was ruled out by doing the procalcitonin test, which was within the normal limit.


PDF Share
  1. Ragab D, Salah Eldin H, Taeimah M, Khattab R, Salem R. The COVID-19 cytokine storm; what we know so far. Front Immunol 2020;16(11):1446. DOI: 10.3389/fimmu.2020.01446. PMID: 32612617; PMCID: PMC7308649.
  2. 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.
  3. Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature 2003;426(6965):450–454. DOI: 10.1038/nature02145.
  4. CDC. 2019 novel coronavirus, Wuhan, China: symptoms. CDC; January 26, 2020 [Accessed: January 27, 2020]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html.
  5. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Napoli RD, et al. Features, evaluation and treatment coronavirus (COVID-19). Stat pearls [internet]. Treasure Island (FL): Stat Pearls Publishing; Jan 2020.
  6. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8(4):420–422. DOI: 10.1016/S2213-2600(20)30076-X.
  7. Chen D, Hu C, Su F, Song O, Wang Z. Exposure to SARS-CoV-2 in a high transmission setting increases the risk of severe COVID-19 compared with exposure to a low transmission setting? J Travel Med 2020;27(5):taaa094. DOI: 10.1093/jtm/taaa094.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.