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

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The most relevant critical clinical picture in CVID19 patients is respiratoryfailure, micro clots in various organs, disseminated intravascular coagulation (DIC) andprogressive multiple organ failure (MOF). The "hyperinflammation" or "cytokinestorm '' is the scenario in which the complement (included C5) attack is triggered. Thisactivity can be detected by the loss of expression of CD88 in the membrane circulatingneutrophils (PMN), and this loss of expression reflects the attack of the complement tothe rest of the organs and tissues, which is accompanied by a state of unmunoparalysisthat favors bacterial infection and sepsis. The drop in the expression of CD88 incirculating PMNs can be a biomarker that announces this sequence of events, and isanticipated between 48-72 hours before the installation of sepsis and / or the multiplefailure of organism. Under these conditions, the monitoring of PMN-CD88 can allowthe concomitant use of Eculizumab as a therapeutic strategy that aborts the complementattack and avoids multiple organ failure in the critical patient, infected by COVID-19.