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Possible Use of Eculizumab in Critically Ill Patients Infected with Covid-19 Role of Complement C5, Neutrophils, and NETs in the Induction DIC, Sepsis, and MOF

image of Possible Use of Eculizumab in Critically Ill Patients Infected with Covid-19 Role of Complement C5, Neutrophils, and NETs in the Induction DIC, Sepsis, and MOF

The most relevant critical clinical picture in CVID19 patients is respiratory failure, micro clots in various organs, disseminated intravascular coagulation (DIC) and progressive multiple organ failure (MOF). The “hyperinflammation” or “cytokine storm '' is the scenario in which the complement (included C5) attack is triggered. This activity can be detected by the loss of expression of CD88 in the membrane circulating neutrophils (PMN), and this loss of expression reflects the attack of the complement to the rest of the organs and tissues, which is accompanied by a state of unmunoparalysis that favors bacterial infection and sepsis. The drop in the expression of CD88 in circulating PMNs can be a biomarker that announces this sequence of events, and is anticipated between 48-72 hours before the installation of sepsis and / or the multiple failure of organism. Under these conditions, the monitoring of PMN-CD88 can allow the concomitant use of Eculizumab as a therapeutic strategy that aborts the complement attack and avoids multiple organ failure in the critical patient, infected by COVID-19.

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