Early theory regarding some virus deaths is nowin doubt

Early in the pandemic, medical researchers rallied around a hypothesis to explain why many coronavirus patients were ending up in the hospital with injured lungs and other organs, struggling to breathe: Perhaps a severe immune reaction, called a cytokine storm, was the culprit.

But several recent studies have cast doubt on aspects of that idea, revealing that certain drugs administered to quell supposed cytokine storms are not nearly as effective as originally thought.

In a cytokine storma body’s defenses go rogue, spewing out powerful compounds — cytokines and other drivers of inflammation — that fatally damage tissues and organs. The hypothesis was that such storms could explain why some patients who died from COVID- 19 were found to have little or no virus in their bodies, because their immune systems eliminated it.

Attention focused on one cytokine in particular, interleukin- 6, or il- 6. Early reports from China and Italy indicated that administering drugs that blocked il- 6 helped some coronavirus patients recover. Anti- il- 6 drugs quickly became a standard of care at many hospitals for treating COVID- 19.

But rigorous studies are failing to fifind that anti- il- 6 drugs are effective for this purpose. Two published in JAMA Internal Medicine and one in the New England Journal

of Medicine found no evidence that a commonly used il- 6 inhibitor, tocilizumab, reduced the death rates in severely ill coronavirus patients.