BACKGROUND

SARS-Cov2 is the last appeared coronavirus that developed a pandemic infection with huge number of fatal cases. No vaccines are yet available that protect from this infection. However, a number of therapeutic tactics against COVID-19 have been empirically started.

According to Mehra et al., 2020, in COVID-19 illness, a structured approach to clinical is imperative (1). Such approach distinguish the phase in which the viral pathogenicity is dominant, from the phase where the host inflammatory response overtakes the pathology. Therefore, after five months of epidemy, 3-stage’s progression of illness, corresponding to increasing severity with distinct clinical signs, therapy responses and clinical outcomes, has been assessed. These stages constitute the reference for investigation and proposition of effective targeted therapies (1).

Stage I is the phase where the early infection causes to most people mild or asymptomatic disease. Treatment at this level with drug having antiviral activity could prevent the progression to severe disease. Stage II (moderate) corresponds to the pulmonary involvement without (IIa) and with (IIb) hypoxia. In this stage the pulmonary disease is established with viral lung multiplication and localized inflammation. The patients develop a viral pneumonia, with cough, fever and possibly hypoxia. Now, not only antiviral drugs are required but, in particular, the inflammation has to be considered and treated. Stage III is the phase in which an extra-pulmonary systemic hyperinflammation syndrome manifests. Likely, a minority of Covid-19 patients transit to this stage where the therapy is essentially against the so called “inflammation storm… Continue reading.