Researchers from The Feinstein Institutes for Medical Research (New York, NY, USA) and Northwell COVID-19 Research Consortium have identified the most effective immunomodulatory therapies to treat COVID-19 patients with evidence of cytokine storm and improve patient survival.

Some immune systems respond to COVID-19 infection by going into overdrive, resulting in an overzealous inflammatory response referred to as a cytokine storm. In a retrospective study of nearly 6,000 patients, a multidisciplinary team of investigators analyzed the electronic health records of hospitalized COVID-19 patients. Patients were divided into one of six groups; no immunomodulatory treatment (standard of care), patients who received intravenous corticosteroids, anti-interleukin 6 antibody therapy (tocilizumab) or anti-interleukin-1 therapy (anakinra) alone or in combination with corticosteroids.

The results showed that the most effective treatment was the combination of corticosteroids - such as dexamethasone - with tocilizumab when compared to standard of care. Additionally, there was an improvement if corticosteroids were used alone, or in combination with tocilizumab or anakinra when compared with standard of care. The researchers hope that the findings are useful for frontline providers to care for severely ill COVID-19 patients and to aid in the future design of large randomized controlled clinical trials, the gold standard of medical research.

“Cytokine storms are a hallmark for many COVID-19 patients and are associated with the most severe form of this illness,” said Dr. Hajizadeh, associate professor at the Zucker School of Medicine at Hofstra/Northwell and co-senior author on the paper. “Our findings suggest that with the intervention of certain drugs like corticosteroids, we can battle the cytokine storm and improve outcomes to the point that we believe we have found a new standard of care for seriously ill patients.”

“Dr. Hajizadeh’s major COVID-19 research study gives timely and crucial new knowledge about using currently available anti-inflammatory drugs,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes. “This information will help others save lives.”

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