Complement Inhibition in Severe COVID-19 Acute Respiratory Distress Syndrome

• Authors: Sharmila Raghunandan, Emory University; Cassandra Josephson, Emory University; Hans Verkerke, Emory University; William Linam, Emory University; Treva C. Ingram, Emory University; Patricia E. Zerra, Aflac Cancer and Blood Disorders Center; Connie M. Arthur, Emory University; Sean Stowell, Emory University; Michael Briones, Emory University; Satheesh Chonat, Emory University
• Journal Title: FRONTIERS IN PEDIATRICS
• Volume: Volume 8
• Publisher: FRONTIERS MEDIA SA | 2020-12-29, Pages 616731-616731
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3389/fped.2020.616731
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Pediatrics; complement; COVID-19; SARS-CoV-2; eculizumab; acute respiratory distress syndrome (ARDS); children; pediatric; ACTIVATION; INJURY

Abstract

Most children with COVID-19 have asymptomatic or mild illness. Those who become critically ill suffer from acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI). The rapid deterioration of lung function has been linked to microangiopathic and immune-mediated processes seen in the lungs of adult patients with COVID-19. The role of complement-mediated acute lung injury is supported by animal models of SARS-CoV, evaluation of lung tissue in those who died from COVID-19 and response of COVID-19 ARDS to complement inhibition. We present a summary of a child with COVID-19 disease treated with convalescent plasma and eculizumab and provide a detailed evaluation of the inflammatory pathways.