PEG reduces cytokine release
Accumulating evidence suggests that a subgroup of patients with severe COVID-19 might have a cytokine storm syndrome which is considered one of the major causes of ARDS and multiple-organ failure (Ye et al., 2020). The serum levels of interleukin 2R (IL-2R) and IL-6 in patients with COVID-19 are positively correlated with the severity of the disease (i.e., critically ill patients > severely ill patients > ordinary patients). PEG has been shown to reduce cytokine release in-vivo and in-vitro . Ackland et al. have shown that low molecular weight PEG reduced IL-6, IL-10 and tumor necrosis factor α (TNFα) release form isolated human peripheral blood mononuclear cells incubated with lipopolysaccharide (LPS) (Ackland et al., 2010). PEG also reduced human neutrophil activation after incubation with LPS or zymosan (Ackland et al., 2010). Recently, it has been shown that intravenous administration of PEG35 in rats protected against acute necrotizing pancreatitis (ANP) associated inflammatory process (Ferrero-Andres et al., 2020). PEG35 was able to downregulate IL-6, IL1-β, TNFα and chemokine ligand 2 (CXCL2) in both pancreas and lung. Histologic findings show that PEG35 treatment normalized alveolar septal thickening and neutrophils infiltration (Ferrero-Andres et al., 2020).