Phase identification is the key to a
prompt immune
modulation
The majority of previous clinical trials indicated that both
immunosuppression and immunomodulation were effective in severe COVID-19
conditions requiring respiratory support and ventilation, while in
non-severe disease phase, immunologic treatments might elicit worse
outcome (e.g., corticosteroid) or no significant improvements of
clinical outcome or mortality. This fits well with the identified
disease pathophysiology (Figure 2 ) implying the
hyperinflammatory state with cytokine release syndrome in severe
COVID-19. In such conditions, inhibition of proinflammatory cytokines
with immunosuppressive agents could reduce the damaging consequences of
rogue inflammation and immunomodulation might restore the host immune
regulation. On the other hand, in the early phase, immunologic
treatments tend to disrupt the activation of immune response against
viruses and therefore, could be detrimental.