Background: Inhibitors of interleukin 6 [IL-6] have been utilized to treat severe COVID-19 disease. Their immunosuppressive or immunomodulating impact may be beneficial in COVID-19. Objectives: To discuss the role of IL-6 inhibitors and assess various trials conducted to evaluate the efficacy of IL-6 inhibitors in COVID-19 disease. Summary: Two of the most common causes of mortality in COVID-19-infected critically ill individuals are acute respiratory distress syndrome (ARDS) and multiorgan failure. Increased levels of inflammatory cytokines suggest that a cytokine storm, also known as cytokine release syndrome (CRS), is involved in the etiology of COVID-19. Most tissue damage, sepsis, and pulmonary and cardiovascular problems are caused mainly by the host defense system. Therefore, regulating this inflammatory cascade using immunomodulators is a prudent strategy. Although corticosteroids, as immunomodulators, are routinely used in COVID-19 management, interleukin (IL) inhibitors, especially IL-6 inhibitors, are also tested in many trials. Many studies have demonstrated that IL-6 inhibitors improve disease outcomes and decrease mortality, whereas others have shown that they are ineffective. In this paper, we briefly examined the role of IL-6 in COVID-19 pathogenesis and trials that support or refute the use of IL-6 inhibitors in treating COVID-19 disease. Results: Though mixed results are coming from trials regarding the adjuvant use of IL-6 inhibitors and standard anti-viral therapy with dexamethasone, a consensus favors using IL-6 inhibitors in severely ill COVID-19 patients regardless of the outcome.

中文翻译：

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白细胞介素 6 拮抗剂治疗严重 COVID-19 疾病：心血管和呼吸系统结果

背景：白细胞介素 6 [IL-6] 抑制剂已用于治疗严重的 COVID-19 疾病。它们的免疫抑制或免疫调节作用可能对 COVID-19 有益。目的：讨论 IL-6 抑制剂的作用并评估为评估 IL-6 抑制剂在 COVID-19 疾病中的疗效而进行的各种试验。摘要：COVID-19 感染的危重患者最常见的两个死亡原因是急性呼吸窘迫综合征 (ARDS) 和多器官衰竭。炎症细胞因子水平升高表明细胞因子风暴，也称为细胞因子释放综合征（CRS），与 COVID-19 的病因有关。大多数组织损伤、败血症以及肺部和心血管问题主要是由宿主防御系统引起的。因此，使用免疫调节剂调节这种炎症级联是一种谨慎的策略。尽管皮质类固醇作为免疫调节剂在 COVID-19 治疗中常规使用，但白细胞介素 (IL) 抑制剂，尤其是 IL-6 抑制剂也在许多试验中进行了测试。许多研究表明 IL-6 抑制剂可以改善疾病结果并降低死亡率，而其他研究则表明它们无效。在本文中，我们简要研究了 IL-6 在 COVID-19 发病机制中的作用以及支持或反驳使用 IL-6 抑制剂治疗 COVID-19 疾病的试验。结果：虽然关于辅助使用 IL-6 抑制剂和地塞米松标准抗病毒治疗的试验结果好坏参半，但无论结果如何，共识都赞成在重症 COVID-19 患者中使用 IL-6 抑制剂。