Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed
Marc Feldmann，Ravinder N Maini，James N Woody，Stephen T Holgate，Gregory Winter
Matthew Rowland
Published:April 09, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30858-8
With more than 81?000 deaths worldwide from coronavirus disease 2019 (COVID-19) by April 8, 2020,1 it is incumbent on researchers to accelerate clinical trials of any readily available and potentially acceptably safe therapies that could reduce the rising death toll. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gains access to host cells via angiotensin-converting enzyme 2, which is expressed in the type II surfactant-secreting alveolar cells of the lungs.2 Severe COVID-19 is associated with a major immune inflammatory response with abundant neutrophils, lymphocytes, macrophages, and immune mediators. Which mediators are most important in driving the immune pathology remains to be elucidated. Deaths from COVID-19 are chiefly due to diffuse alveolar damage with pulmonary oedema, hyaline membrane formation, and interstitial mononuclear inflammatory infiltrate compatible with early-phase adult respiratory distress syndrome (ARDS).3 Prevention of ARDS and death in patients with COVID-19 is a pressing health emergency.
