Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome
Objectives: One-fifth of Covid-19 patients suffer a severe course of Covid-19 infection; however, the specific causes remain unclear. Mast cells (MCs) are activated by SARS-CoV-2. Although only recently recognized, MC activation syndrome (MCAS), usually due to acquired MC clonality, is a chronic mul...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-11-01
|
| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220307323 |
| _version_ | 1828968634142162944 |
|---|---|
| author | Lawrence B. Afrin Leonard B. Weinstock Gerhard J. Molderings |
| author_facet | Lawrence B. Afrin Leonard B. Weinstock Gerhard J. Molderings |
| author_sort | Lawrence B. Afrin |
| collection | DOAJ |
| description | Objectives: One-fifth of Covid-19 patients suffer a severe course of Covid-19 infection; however, the specific causes remain unclear. Mast cells (MCs) are activated by SARS-CoV-2. Although only recently recognized, MC activation syndrome (MCAS), usually due to acquired MC clonality, is a chronic multisystem disorder with inflammatory and allergic themes, and an estimated prevalence of 17%. This paper describes a novel conjecture explaining how MCAS might cause a propensity for severe acute Covid-19 infection and chronic post-Covid-19 illnesses. Methods: Observations of Covid-19 illness in patients with/without MCAS were compared with extensive clinical experience with MCAS. Results: The prevalence of MCAS is similar to in agreement with that of severe cases within the Covid-19-infected population. Much of Covid-19’s hyperinflammation is concordant with manners of inflammation which MC activation can drive. Drugs with activity against MCs or their mediators have preliminarily been observed to be helpful in Covid-19 patients. None of the authors treated MCAS patients with Covid-19 suffered severe infection, let alone mortality. Conclusions: Hyperinflammatory cytokine storms in many severely symptomatic Covid-19 patients may be rooted in an atypical response to SARS-CoV-2 by the dysfunctional MCs of MCAS rather than a normal response by normal MCs. If proven, this theory has significant therapeutic and prognostic implications. |
| first_indexed | 2024-12-14T12:15:19Z |
| format | Article |
| id | doaj.art-e9bfcec1eb6e4d6b967ce54498eac174 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-14T12:15:19Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-e9bfcec1eb6e4d6b967ce54498eac1742022-12-21T23:01:39ZengElsevierInternational Journal of Infectious Diseases1201-97122020-11-01100327332Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndromeLawrence B. Afrin0Leonard B. Weinstock1Gerhard J. Molderings2Department of Mast Cell Studies, AIM Center for Personalized Medicine, Purchase, New York, USA; Corresponding author at: Department of Mast Cell Studies, AIM Center for Personalized Medicine, 3010 Westchester Avenue, Suite 404, Purchase, NY 10577, USA.Department of Medicine, Washington University, St. Louis, Missouri, USAInstitute of Human Genetics, University Hospital of Bonn, Bonn, GermanyObjectives: One-fifth of Covid-19 patients suffer a severe course of Covid-19 infection; however, the specific causes remain unclear. Mast cells (MCs) are activated by SARS-CoV-2. Although only recently recognized, MC activation syndrome (MCAS), usually due to acquired MC clonality, is a chronic multisystem disorder with inflammatory and allergic themes, and an estimated prevalence of 17%. This paper describes a novel conjecture explaining how MCAS might cause a propensity for severe acute Covid-19 infection and chronic post-Covid-19 illnesses. Methods: Observations of Covid-19 illness in patients with/without MCAS were compared with extensive clinical experience with MCAS. Results: The prevalence of MCAS is similar to in agreement with that of severe cases within the Covid-19-infected population. Much of Covid-19’s hyperinflammation is concordant with manners of inflammation which MC activation can drive. Drugs with activity against MCs or their mediators have preliminarily been observed to be helpful in Covid-19 patients. None of the authors treated MCAS patients with Covid-19 suffered severe infection, let alone mortality. Conclusions: Hyperinflammatory cytokine storms in many severely symptomatic Covid-19 patients may be rooted in an atypical response to SARS-CoV-2 by the dysfunctional MCs of MCAS rather than a normal response by normal MCs. If proven, this theory has significant therapeutic and prognostic implications.http://www.sciencedirect.com/science/article/pii/S1201971220307323Covid-19SARS-CoV-2Mast cell activation syndromeMast cell activation diseaseMedical hypothesis |
| spellingShingle | Lawrence B. Afrin Leonard B. Weinstock Gerhard J. Molderings Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome International Journal of Infectious Diseases Covid-19 SARS-CoV-2 Mast cell activation syndrome Mast cell activation disease Medical hypothesis |
| title | Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome |
| title_full | Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome |
| title_fullStr | Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome |
| title_full_unstemmed | Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome |
| title_short | Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome |
| title_sort | covid 19 hyperinflammation and post covid 19 illness may be rooted in mast cell activation syndrome |
| topic | Covid-19 SARS-CoV-2 Mast cell activation syndrome Mast cell activation disease Medical hypothesis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220307323 |
| work_keys_str_mv | AT lawrencebafrin covid19hyperinflammationandpostcovid19illnessmayberootedinmastcellactivationsyndrome AT leonardbweinstock covid19hyperinflammationandpostcovid19illnessmayberootedinmastcellactivationsyndrome AT gerhardjmolderings covid19hyperinflammationandpostcovid19illnessmayberootedinmastcellactivationsyndrome |