Evidence map›Paper›PMID 32920235›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2020

Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome.

Lawrence B Afrin, Leonard B Weinstock, Gerhard J Molderings

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 177 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
177citing papers in PubMed, 3 pooled it
19.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

177 citing papers in PubMed, 3 syntheses or guidelines pooled it, 325 citations in OpenAlex.

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  6. Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID-19.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2021
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  9. Overlapping Clinical Presentation of Long COVID and Postacute COVID-19 Vaccination Syndrome: Phenotypes, Severity, and Biomarkers.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
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117 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

Lawrence B AfrinDepartment of Mast Cell Studies, AIM Center for Personalized Medicine, Purchase, New York, USA. Electronic address: drafrin@armonkmed.com.
Leonard B WeinstockDepartment of Medicine, Washington University, St. Louis, Missouri, USA.
Gerhard J MolderingsInstitute of Human Genetics, University Hospital of Bonn, Bonn, Germany.
Purchase College · USUniversity Hospital Bonn · DEWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOne-fifth of Covid-19 patients suffer a severe course of Covid-19 infection; however, the specific causes remain unclear. Mast cells (MCs) are activated by SARS-CoV-2. Although only recently recognized, MC activation syndrome (MCAS), usually due to acquired MC clonality, is a chronic multisystem disorder with inflammatory and allergic themes, and an estimated prevalence of 17%. This paper describes a novel conjecture explaining how MCAS might cause a propensity for severe acute Covid-19 infection and chronic post-Covid-19 illnesses.

methodsObservations of Covid-19 illness in patients with/without MCAS were compared with extensive clinical experience with MCAS.

resultsThe prevalence of MCAS is similar to that of severe cases within the Covid-19-infected population. Much of Covid-19's hyperinflammation is concordant with manners of inflammation which MC activation can drive. Drugs with activity against MCs or their mediators have preliminarily been observed to be helpful in Covid-19 patients. None of the authors' treated MCAS patients with Covid-19 suffered severe infection, let alone mortality.

conclusionsHyperinflammatory cytokine storms in many severely symptomatic Covid-19 patients may be rooted in an atypical response to SARS-CoV-2 by the dysfunctional MCs of MCAS rather than a normal response by normal MCs. If proven, this theory has significant therapeutic and prognostic implications.

Indexed as

COVID-19HumansInflammationMast CellsMastocytosisPandemicsSARS-CoV-2Covid-19Mast cell activation diseaseMast cell activation syndromeMedical hypothesisSARS-CoV-2

Identifiers

PMID32920235
PMCPMC7529115
OpenAlexW3086293749

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.