key: cord-0800570-fw8z6sqi
authors: nan
title: PROPOSED USE OF THALIDOMIDE FOR THE CYTOKINE STORM OF COVID-19
date: 2020-04-28
journal: Clin Dermatol
DOI: 10.1016/j.clindermatol.2020.04.015
sha: cd2e0ae8f9d12b5c565f1eb93c1a2a1771833879
doc_id: 800570
cord_uid: fw8z6sqi

nan

J o u r n a l P r e -p r o o f

A cytokine storm is charged with being the mechanism explaining much of the morbidity and mortality of current cases of COVID-19

Several medications that have no direct antiviral action have been used to treat this cytokine storm. Among these, Chloroquine or derivatives therefrom. I wondered whether oral thalidomide might not be of good use in this respect. This drug was used initially for a similar purpose with great success, by Convit , Soto and Sheskin to allay reactional phenomena in reactional lepromatous leprosy(1). We (Goihman-Yahr, Requena, Vallecalle-Suegart and Convit) used thalidomide in experimental autoimmune diseases of the rat (2). We found that the drug administered intragastrically in rats was effective in preventing and treating "distant lesions" of adjuvant disease. Namely, arthritis, vasculitis of the skin and iridocyclitis; as well as loss of weight and wasting. It was NOT effective in treating or preventing experimental allergic encephalomyelitis or experimental allergic neuritis. We (Goihman-Yahr, Rodriguez-Ochoa, Aranzazu and Convit) also found that peripheral blood neutrophils were activated in reactional lepromatous leprosy, but not in other forms of leprosy. This was not due to anergy of neutrophils in non reactional leprosy (3).

I have NO direct experience, nor a feasible way to personally test thalidomide in the serious late phase of COVID 19; but suggest that its use should be considered (in patients that are not women of child-bearing age) to prevent or treat patients with this condition. The possible side effects of thalidomide are detailedly covered in Martindale´s, "The Complete Drug Reference" (4) but most of them occur in patients with complex pathologies including malignant neoplasia. In my long term clinical experience with the drug, the only frequent side effect besides sleepiness, is alteration in peripheral nerve conduction with prolonged administration.

Thalidomide therapy in the lepra reaction

Autoimmune diseases and Thalidomide II

Polymorphonuclear Activation in Leprosy I

Editor) Thalidomide. In Martindale. The Complete Drug Reference 37 th Edition Pp 2634-2637Pharmaceutical Press

Professor (E) of Dermatology and Immunology Vargas School of Medicine,Central University of Venezuela Full Member(Chair XVII) National Academy of Medicine, Caracas VENEZUELA E mail mgoihmanyahr@yahoo