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Frontiers in Clinical Drug Research: Hematology

Volume: 5

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Possible Use of Eculizumab in Critically Ill Patients Infected with Covid-19 Role of Complement C5, Neutrophils, and NETs in the Induction DIC, Sepsis, and MOF

Author(s): Alberto Lazarowski *

Pp: 168-191 (24)

DOI: 10.2174/9789815039535122050008

* (Excluding Mailing and Handling)

Abstract

The most relevant critical clinical picture in CVID19 patients is respiratory
failure, micro clots in various organs, disseminated intravascular coagulation (DIC) and
progressive multiple organ failure (MOF). The “hyperinflammation” or “cytokine
storm '' is the scenario in which the complement (included C5) attack is triggered. This
activity can be detected by the loss of expression of CD88 in the membrane circulating
neutrophils (PMN), and this loss of expression reflects the attack of the complement to
the rest of the organs and tissues, which is accompanied by a state of unmunoparalysis
that favors bacterial infection and sepsis. The drop in the expression of CD88 in
circulating PMNs can be a biomarker that announces this sequence of events, and is
anticipated between 48-72 hours before the installation of sepsis and / or the multiple
failure of organism. Under these conditions, the monitoring of PMN-CD88 can allow
the concomitant use of Eculizumab as a therapeutic strategy that aborts the complement
attack and avoids multiple organ failure in the critical patient, infected by COVID-19.

Keywords: Complement C5, COVID-19, Eculizumab, MOF, PMN-CD88.

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