NEUROLOGICAL RISKS AND BENEFITS OF CYTOKINE-BASED TREATMENTS IN COVID-19: FROM PRECLINICAL TO CLINICAL EVIDENCE

Immunodeficiency and hyperinflammation are responsible for the most frequent and life-threatening forms of COVID-19; therefore, cytokines-based treatments targeting immuno-inflammatory mechanisms are currently undergoing clinical scrutiny in COVID-19-affected patients. In addition, COVID-19 patients also exhibit a wide range of neurological manifestations (neuro-COVID) which could also benefit from cytokine-based treatments. In fact, these drugs showed some clinical efficacy also in neuroinflammatory diseases. On the other hand, anti-cytokine drugs are endowed with significant neurological risks, mainly attributable to their immune-depressant effects. Therefore, the aim of the present manuscript is to briefly describe the role of specific cytokines in neuroinflammation, to summarize the efficacy in preclinical models of neuroinflammatory diseases of drugs targeting these cytokines, and to review the clinical data regarding the neurological effects of these drugs currently being investigated against COVID-19, in order to raise awareness about their potentially beneficial and/or detrimental neurological consequences.