Cytokine storm in COVID-19 and the treatment simulacrum

Following the outbreak of the severe acute respiratory syndrome-coronavirus (SARS-CoV-2) in December 2019 at Wuhan, China, it spread through the world rapidly, and this disease was declared as a pandemic by the World Health Organization on March 11, 2020. A high mortality rate has been detected due to this respiratory involvement; this novel virus like the previous ones, SARS-CoV-1, from this family, can lead to lethal pneumonia, acute lung injury, and eventually acute respiratory distress syndrome (ARDS), which was reported in 20% of patients. Surprisingly, this ARDS can have a mortality rate of 40%-50%. As it is known that infection can manifest in a wide variety of symptoms, from a mild respiratory disease to life-threatening ARDS, multiorgan dysfunction, shock, and death, the exact mechanism of this ARDS in COVID-19 pneumonia is not known completely. There are ongoing studies, but the term "cytokine storm" can be a possible clue of the transformation of a mild disease to a lethal one, and also an explanation of this rapid and deadly inflammatory response which take a place in the lungs. Our goal in this review is to express a better definition of molecular and cellular pathways of cytokine storms and also discuss some recent trials of the effect of different classes of drugs on this immunologic and inflammatory pathway of CoV infection. In this study, we have addressed evidences for more efficient immunomodulatory drugs for this vivid storm.