Figures
Figure 1. Hypothetical model of dexamethasone mode of action involving inhibition of the cytokine storm and induction of proresolving lipids such as Protectin D1 (PD1) and Resolvin D4.SARS-CoV2 infection induces hyperinflammation characterized by a ‘cytokine storm’ involving TNF, IL-1, Il-6, IL-8 and IP-10 production and release of eicosanoids. SARS-CoV2 infection also induces proresolving meditators including protectins, resolvins and maresins as an effort to counter-balance the system. These act to reduce inflammation and promote its resolution but are also help resolve coagulation and block viral replication. Strengthening this response through the temporal administration of dexamethasone which triggers in addition to its conventional anti-inflammatory effects the D-series protectins results in notable benefit in patients.