The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 presents with a spectrum of clinical manifestations from asymptomatic or mild, self-limited constitutional symptoms to a hyperinflammatory state (“cytokine storm”) followed by acute respiratory distress syndrome and death. The objective of this study was to provide an evidence-based review of the associated pathways and potential treatment of the hyperinflammatory state associated with severe acute respiratory syndrome coronavirus 2 infection. Dysregulated immune responses have been reported to occur in a smaller subset of those infected with severe acute respiratory syndrome coronavirus 2, leading to clinical deterioration 7 to 10 days after initial presentation. A hyperinflammatory state referred to as cytokine storm in its severest form has been marked by elevation of IL-6, IL-10, TNF-α, and other cytokines and severe CD4⁺ and CD8⁺ T-cell lymphopenia and coagulopathy. Recognition of at-risk patients could permit early institution of aggressive intensive care and antiviral and immune treatment to reduce the complications related to this proinflammatory state. Several reports and ongoing clinical trials provide hope that available immunomodulatory therapies could have therapeutic potential in these severe cases. This review highlights our current state of knowledge of immune mechanisms and targeted immunomodulatory treatment options for the current coronavirus disease 2019 pandemic.

由严重急性呼吸系统综合症冠状病毒 2 引起的 2019 年冠状病毒病大流行具有一系列临床表现，从无症状或轻微、自限性全身症状到过度炎症状态（“细胞因子风暴”），随后出现急性呼吸窘迫综合征和死亡。本研究的目的是对与严重急性呼吸系统综合症冠状病毒 2 感染相关的过度炎症状态的相关途径和潜在治疗方法进行循证审查。据报道，一小部分感染严重急性呼吸系统综合症冠状病毒 2 的人会出现免疫反应失调，导致初次出现后 7 至 10 天出现临床恶化。⁺和 CD8 ⁺ T 细胞淋巴细胞减少症和凝血病。识别处于危险中的患者可以允许及早建立积极的重症监护以及抗病毒和免疫治疗，以减少与这种促炎状态相关的并发症。一些报告和正在进行的临床试验提供了希望，即可用的免疫调节疗法可能在这些严重病例中具有治疗潜力。这篇综述强调了我们目前对免疫机制和针对当前冠状病毒病 2019 大流行的靶向免疫调节治疗方案的了解。