What is the Covid-19 Cytokine Storm? Medically Reviewed By: Caron A. Jacobson, MD, MMSc for Dana-Farber Cancer Institute
A cytokine storm is a severe immune system reaction to infection, autoimmune condition, or other disease, including some cancers. It occurs when the body produces extremely high levels of certain cytokines, which are proteins that raise or lower immune activity.
The deluge of cytokines into the bloodstream can result in severe inflammation across multiple bodily systems, organ dysfunction, and organ failure if not treated adequately.
Cytokine storm can be an especially dangerous result of COVID-19. The inflammation and fluid buildup in the lungs associated with the disease may deprive the body of sufficient oxygen and require patients to be placed on a mechanical ventilator.
What causes cytokine storm?
It isn’t clear why some patients develop cytokine storm while others with the same disease don’t, but it arises when the body overproduces certain immune-stimulating cytokines in response to an infection or other disease or to a medical treatment. The immune response normally operates under strict controls, ramping up to fight disease and standing down with the job is done. With cytokine storm, the response is out of proportion, resulting in impaired function and damaged tissue.
What conditions can trigger cytokine storm?
- Macrophage activation syndrome, a severe complication of rheumatic disease in childhood, resulting in the uncontrolled activation and proliferation of T cells and macrophages — types of immune system cells
- Some viral infections, such as the one responsible for COVID-19
- Leukemia and lymphoma
- Hemophagocytic lymphohistiocytosis, a rare disease in which white blood cells called histiocytes and lymphocytes attack other blood cells
What treatments can give rise to cytokine storm?
CAR T-cell therapy, a form of immunotherapy approved for the treatment of adults with B cell lymphoma, mantle cell lymphoma, and multiple myeloma, and children and young adults with acute lymphoblastic leukemia, is linked to cytokine release syndrome (CRS) — a form of cytokine storm — in some patients.