Targeting the catecholamine-cytokine axis to prevent SARS-CoV-2 cytokine storm syndrome

  1. Maximilian F. Konig
  2. Mike Powell
  3. Verena Staedtke
  4. Ren-Yuan Bai
  5. David L. Thomas
  6. Nicole Fischer
  7. Sakibul Huq
  8. Adham M. Khalafallah
  9. Allison Koenecke
  10. Ruoxuan Xiong
  11. Brett Mensh
  12. Nickolas Papadopoulos
  13. Kenneth W. Kinzler
  14. Bert Vogelstein
  15. Joshua T. Vogelstein
  16. Susan Athey
  17. Shibin Zhou
  18. Chetan Bettegowda

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Abstract

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 (α 1 -AR) antagonists can prevent hyperinflammation (“cytokine storm”) and death in mice. We here present clinical data that supports the use of α 1 -AR antagonists in the prevention of severe complications of pneumonia, ARDS, and COVID-19.

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    SciScore for 10.1101/2020.04.02.20051565: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.04.02.20051565v2 on medRxiv
  3. Version published to 10.1101/2020.04.02.20051565v1 on medRxiv