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.