ReviewFrontiers in immunology2020
Overview: Systemic Inflammatory Response Derived From Lung Injury Caused by SARS-CoV-2 Infection Explains Severe Outcomes in COVID-19.
Review in Frontiers in immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04909918 (The Impact of Dexamethasone Versus Methylprednisolone Upon Neutrophil/Lymphocyte Ratio), which is not on this map. Cited by 126 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Dexamethasone Versus Methylprednisolone Upon Neutrophil/Lymphocyte Ratio (NLR) in COVID-19 Diseased Patients Admitted in ICU
Who cites it
126 citing papers in PubMed, 1 synthesis or guideline pooled it, 207 citations in OpenAlex.
- Mucosal immune response in biology, disease prevention and treatment.Signal transduction and targeted therapy · 2025Pooled it
- Impact of vitamin D supplementation on the clinical outcomes of COVID-19 pneumonia patients: a single-center randomized controlled trial.BMC complementary medicine and therapies · 2024Trial
- Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial.PLoS medicine · 2021Trial
- Electroacupuncture pretreatment alleviates myocardial ischemia/reperfusion-induced lung injury by inhibiting the expression of HMGB1/RAGE in male rats.Physiological reports · 2026Article
- Involvement of NLRP3 Inflammasome in Methamphetamine Augmentation of SARS-CoV-2 N-Protein-Induced Neuroinflammation in Rat Microglial Cells.International journal of molecular sciences · 2026Article
- Article
- Effects of graphene photothermal adjuvant therapy in patients infected with the Omicron BF.7 variant 2022: a prospective randomized controlled trial.Scientific reports · 2026Article
- Cannabidiol mitigates secondary genital injury after thoracic trauma by regulating systemic inflammation and hormone receptor signaling.Scientific reports · 2026Article
- Integrative Vitamin D-Inflammatory-Coagulation Biomarker Index Predicts COVID-19 Severity: Development and Validation of the Vitamin D Inflammatory Burden Score (VDIBS).International journal of molecular sciences · 2026Article
- Association of ulinastatin with 28-day mortality across different severities of viral pneumonia: a multicenter propensity score-matched study.Frontiers in pharmacology · 2026Article
- Mechanisms and clinical research progress of IL-6-mediated crosstalk between the alveolar microenvironment and the immune system in patients with severe pneumonia undergoing mechanical ventilation.Frontiers in immunology · 2026Review
- Bridging iron and lung injury: the emerging role of ferroptosis in ARDS.European journal of medical research · 2025Review
- Observational
- A Spike-Accum bioconjugate protein vaccine confers potent SARS-CoV-2-specific immunity.iScience · 2025Article
- Long-Term Cardiopulmonary Function After COVID-19-Associated Acute Respiratory Distress Syndrome: A Multicenter Case-Control Study.Critical care explorations · 2025Article
- Small but Mighty: Nanobodies in the Fight Against Infectious Diseases.Biomolecules · 2025Review
- Nutritional Risk Score (NRS-2002) as a Predictor of In-Hospital Mortality in COVID-19 Patients: A Retrospective Single-Center Cohort Study.Nutrients · 2025Article
- Integrating the AEuropean journal of medical research · 2025Article
- The Role of Sterile Inflammation in Thrombosis: Consequences for Cardiovascular Disease and COVID-19.Mediators of inflammation · 2025Review
- Machine learning-based predictive model for high- grade cytokine release syndrome in chimeric antigen receptor T-cell therapy.Frontiers in immunology · 2025Observational
66 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most SARS-CoV2 infections will not develop into severe COVID-19. However, in some patients, lung infection leads to the activation of alveolar macrophages and lung epithelial cells that will release proinflammatory cytokines. IL-6, TNF, and IL-1β increase expression of cell adhesion molecules (CAMs) and VEGF, thereby increasing permeability of the lung endothelium and reducing barrier protection, allowing viral dissemination and infiltration of neutrophils and inflammatory monocytes. In the blood, these cytokines will stimulate the bone marrow to produce and release immature granulocytes, that return to the lung and further increase inflammation, leading to acute respiratory distress syndrome (ARDS). This lung-systemic loop leads to cytokine storm syndrome (CSS). Concurrently, the acute phase response increases the production of platelets, fibrinogen and other pro-thrombotic factors. Systemic decrease in ACE2 function impacts the Renin-Angiotensin-Kallikrein-Kinin systems (RAS-KKS) increasing clotting. The combination of acute lung injury with RAS-KKS unbalance is herein called COVID-19 Associated Lung Injury (CALI). This conservative two-hit model of systemic inflammation due to the lung injury allows new intervention windows and is more consistent with the current knowledge.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.