One of the extraordinary aspects of the pathophysiology of COVID-19 is the so-called “Cytokine Storm”. This is implicated both in the adult type condition, and as part of the PIMTS-TS / MIS-C condition.
We were lucky to spend time talking with Prof Ram from Bristol, a paediatric rheumatologist with an interest in cytokines. What is the difference between biologics and small molecules? What is the future of cytokine blockade?
Specifically, which cytokines are involved in PIMS-TS / MIS-C? Should we blockade them? What is the difference between all the inflammatory conditions, eg PIMS-TS/ MIS-C, toxic shock syndrome, HLH, and even sepsis? When should we use IVIG, steroids, or a targeted biologic?
And, as an aside, why is the COVID mortality so high in certain high income countries, and so low in many low income countries?
Enjoy and learn!
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